Male patient with euthyroid state presents with the following condition

Ans. (b) Multiple nodular goiterRef.: Bailey & Love 26th ed. / 749* Notice the multiple enlarged lobes of this multiple nodular goiter which represents a spectrum of disease ranging from a single hyper-functioning nodule (toxic adenoma) within a multi-nodular thyroid to a gland with multiple areas of hyper function.* Thyroglossal cyst is ruled out as it is present in midline.* The answer should not be given as toxic nodular goiter because we cannot comment on thyrotoxicosis status of patient as eye signs etc. are not visible or given and the question also mentions a EUTHYROID status of the patient.* Autonomous hyperactivity is conferred by somatic mutations of the thyrotropin, or thyroid-stimulating hormone (TSH), receptor in 20-80% of toxic adenomas and some nodules of multinodular goiters. Autonomously functioning nodules may become toxic in 10% of patients.* Hyperthyroidism predominantly occurs when single nodules are larger than 2.5 cm in diameter. Signs and symptoms of TNG are similar to those of other types of hyperthyroidism.