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Nodular hyperplasia is the most common disease afflicting thyroid gland. It has been referred to by a variety of names, including adenomatoid hyperplasia, nodular/multinodular goiter, and adenomatoid goiter. The endemic form is secondary to dietary iodine deficiency. In the sporadic form of the disease, the etiopathology is unknown. Most patients are clinically euthyroid and blood levels of thyroid hormones are not elevated. In some cases, the gland can become considerably enlarged causing disfigurement (such as seen here) and even tracheal obstruction.