{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:00:30Z","timestamp":1790006430728,"version":"4.0.1"},"reference-count":24,"publisher":"Bioscientifica","issue":"9","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The objective of this study is to systematically characterize the presentation, management, and outcomes of arterial complications secondary to benign thyroid enlargement, thereby improving clinical recognition and management of this rare entity. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across PubMed, Web of Science, Embase, and Scopus for studies published from January 1990 to February 2026. This review was registered with PROSPERO CRD420251156228. Studies describing arterial compression, displacement, stenosis, or occlusion attributable to benign thyroid pathology were included. Ten studies met the inclusion criteria, comprising 10 patients with a median age of 66 years, of whom 80% were female. Six patients presented with acute neurologic symptoms, including limb-shaking episodes and lateralized weakness, while the remainder exhibited subacute or chronic compressive complaints. Computed tomography with or without angiography was the primary diagnostic modality. The common carotid artery was involved in nine patients, including bilateral compression in two patients. Multinodular goiter was the most common pathology, with goiter sizes reaching up to 15 cm. Surgical management via thyroidectomy was performed in five patients, while the others were managed conservatively. Follow-up was documented in only five of the ten patients; in each of these, symptoms resolved without reported recurrence, while the remaining five reports contained no post-treatment follow-up data. In conclusion, benign thyroid enlargement is a rare but clinically significant cause of cervical arterial compression that can precipitate neurologic symptoms mimicking cerebrovascular disease. Cross-sectional imaging is essential for diagnosis, and both surgical decompression and conservative strategies were followed by symptom resolution in the cases with documented follow-up. Because the evidence base comprises ten single-patient reports with incomplete follow-up, no objective outcome measures, and no comparative data, certainty of evidence is very low, and these findings should be regarded as hypothesis-generating rather than as guidance for management.<\/jats:p>","DOI":"10.1530\/ec-26-0521","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:30:11Z","timestamp":1788535811000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":0,"title":["Systematic review of benign thyroid enlargement as a rare cause of arterial compression: clinical presentations and outcomes"],"prefix":"10.1530","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4023-0626","authenticated-orcid":true,"given":"Ammar Matthew","family":"Hudefi","sequence":"first","affiliation":[{"name":"University of Arkansas for Medical Sciences (UAMS) College of Medicine 1 , , ,","place":["Little Rock, Arkansas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Bogart","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences (UAMS) College of Medicine 1 , , ,","place":["Little Rock, Arkansas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenny","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Arkansas for Medical Sciences 2 , , ,","place":["Little Rock, Arkansas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Blake","sequence":"additional","affiliation":[{"name":"UAMS Library 3 , , ,","place":["Little Rock, Arkansas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa","family":"Robbins","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences (UAMS) College of Medicine 1 , , ,","place":["Little Rock, Arkansas, USA"]},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Arkansas for Medical Sciences 2 , , ,","place":["Little Rock, Arkansas, USA"]},{"name":"Baptist Health UAMS Ear, Nose, and Throat Clinic 4 , , ,","place":["Little Rock, Arkansas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anvesh","family":"Kompelli","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences (UAMS) College of Medicine 1 , , ,","place":["Little Rock, Arkansas, USA"]},{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Arkansas for Medical Sciences 2 , , ,","place":["Little Rock, Arkansas, USA"]},{"name":"Baptist Health UAMS Ear, Nose, and Throat Clinic 4 , , ,","place":["Little Rock, Arkansas, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"2026092111064765000_bib1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/bmb\/ldr030","article-title":"The epidemiology of thyroid disease","volume":"99","author":"Vanderpump","year":"2011","journal-title":"Br Med Bull"},{"key":"2026092111064765000_bib2","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1001\/jama.2015.0956","article-title":"The natural history of benign thyroid nodules","volume":"313","author":"Durante","year":"2015","journal-title":"JAMA"},{"key":"2026092111064765000_bib3","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.beem.2008.09.019","article-title":"Epidemiology of thyroid nodules","volume":"22","author":"Dean","year":"2008","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"2026092111064765000_bib4","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1056\/NEJMcp031436","article-title":"Clinical practice. The thyroid nodule","volume":"351","author":"Heged\u00fcs","year":"2004","journal-title":"N Engl J Med"},{"key":"2026092111064765000_bib5","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.ijsu.2007.02.003","article-title":"A new classification system for retrosternal goitre based on a systematic review of its complications and management","volume":"6","author":"Huins","year":"2008","journal-title":"Int J Surg"},{"key":"2026092111064765000_bib6","first-page":"827","article-title":"Surgical management of substernal goiter","volume":"99","author":"Shai","year":"2000","journal-title":"J Formos Med Assoc"},{"key":"2026092111064765000_bib7","article-title":"The radiological assessment of carotid space lesions: a case series","volume":"16","author":"Jerosha","year":"2024","journal-title":"Cureus"},{"key":"2026092111064765000_bib8","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/j.otc.2012.08.012","article-title":"Imaging of the carotid space","volume":"45","author":"Kuwada","year":"2012","journal-title":"Otolaryngol Clin North Am"},{"key":"2026092111064765000_bib9","article-title":"Ischemic stroke: a rare complication of a large multinodular goiter","volume":"2022","author":"Camacho","year":"2022","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"2026092111064765000_bib10","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.jstrokecerebrovasdis.2009.02.007","article-title":"An unusual cause of transient neurologic deficits: compression of the carotid artery by a thyroid cystic nodule","volume":"19","author":"Braakman","year":"2010","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2026092111064765000_bib11","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.3390\/jcm14051743","article-title":"The effect of thyroid Lobe volume on the common carotid artery blood flow in thyroidectomy position","volume":"14","author":"Hat\u0131no\u011flu","year":"2025","journal-title":"J Clin Med"},{"key":"2026092111064765000_bib12","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"2026092111064765000_bib13","first-page":"165","article-title":"\u00c7avu\u015fo\u011flu IG Bovine-type aortic arch and compression of the kissing carotid arteries by a retrosternal goiter: an uncommon cause of carotid bruit","volume":"46","author":"Aykan","year":"2018","journal-title":"Turk Kardiyol Dern Ars"},{"key":"2026092111064765000_bib14","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijso.2021.100433","article-title":"Acute suppurative thyroiditis progressing to a thyroid abscess; a case report with review of literature","volume":"38","author":"Baba","year":"2022","journal-title":"Int J Surg Open"},{"key":"2026092111064765000_bib15","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1111\/head.13011","article-title":"New daily persistent headache caused by a multinodular goiter and headaches associated with thyroid disease","volume":"57","author":"Evans","year":"2017","journal-title":"Headache"},{"key":"2026092111064765000_bib16","doi-asserted-by":"crossref","first-page":"e64","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.03.018","article-title":"Stroke in association with thyroid goitre: a case report","volume":"28","author":"Fernandes","year":"2019","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2026092111064765000_bib17","article-title":"Anaesthetic management of a large multi-nodular goitre with dynamic bilateral carotid artery compression","volume":"13","author":"Milder","year":"2025","journal-title":"Anaesth Rep"},{"key":"2026092111064765000_bib18","first-page":"177","article-title":"Syncope in a patient with spontaneous hemorrhage into a thyroid nodule","volume":"18","author":"Sahin","year":"2014","journal-title":"Hippokratia"},{"key":"2026092111064765000_bib19","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/BF02333865","article-title":"Vascular compression from goiter as an unusual cause of cerebrovascular accident","volume":"11","author":"Silvestri","year":"1990","journal-title":"Ital J Neurol Sci"},{"key":"2026092111064765000_bib20","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1111\/head.12315","article-title":"Trigeminal autonomic headaches caused by a multinodular goiter \u2013 a case report","volume":"54","author":"Smit","year":"2014","journal-title":"Headache"},{"key":"2026092111064765000_bib21","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1161\/01.STR.16.3.444","article-title":"Limb shaking--a carotid TIA","volume":"16","author":"Baquis","year":"1985","journal-title":"Stroke"},{"key":"2026092111064765000_bib22","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1159\/000327683","article-title":"Cerebral hemodynamic failure presenting as limb-shaking transient ischemic attacks","volume":"3","author":"Nedelmann","year":"2011","journal-title":"Case Rep Neurol"},{"key":"2026092111064765000_bib23","doi-asserted-by":"crossref","first-page":"371","DOI":"10.4103\/2230-8210.95674","article-title":"Imaging of the thyroid: recent advances","volume":"16","author":"Chaudhary","year":"2012","journal-title":"Indian J Endocrinol Metab"},{"key":"2026092111064765000_bib24","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1001\/archsurg.140.1.49","article-title":"Surgical management of multinodular goiter with compression symptoms","volume":"140","author":"R\u00edos","year":"2005","journal-title":"Arch Surg"}],"container-title":["Endocrine Connections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.bioscientifica.com\/ec\/article-pdf\/doi\/10.1530\/EC-26-0521\/524932\/ec-26-0521.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/ec\/article-pdf\/doi\/10.1530\/EC-26-0521\/524932\/ec-26-0521.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T15:06:54Z","timestamp":1790003214000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.bioscientifica.com\/ec\/article\/15\/9\/e260521\/78158\/Systematic-review-of-benign-thyroid-enlargement-as"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":24,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1530\/ec-26-0521","relation":{},"ISSN":["2049-3614"],"issn-type":[{"value":"2049-3614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]},"article-number":"e260521"}}