Multinodal goitres usually develop from simple goitres. The enlarging goitre can cause compression of neck structures such as trachea or oesophagus. Malignancy is low: 3-5% of cases. Such goitres may be associated with hypothyroidism or hyperthyroidism.
How simple goitres over time transform into multinodular goitre is yet to be fully understood. The heterogeneity in the function of thyroid follicular cells may be responsible for the characteristic heterogeneity of shape and function among newly generated follicles.
Most commonly affects middle aged women and can occur sporadically or endemically.