A goiter is an abnormal enlargement of the thyroid gland. It may be caused by a benign overgrowth of cysts and nodules in the thyroid gland, called multinodular goiter. Risk factors may include iodine deficiency or genetics and Graves’ disease. A goiter can be accompanied by hypothyroidism or hyperthyroidism, but thyroid function is frequently normal. A large goiter can cause compression of the trachea and esophagus, which can lead to difficulty in swallowing or breathing. When the goiter grows larger, it can sometimes become visible as a large gland and can become a cosmetic concern as well. Goiters may need observation only and no further treatment, if there are not any nodules suspected to be cancerous, or they can be removed with a thyroidectomy, if they become bothersome.