Thyroid Surgery- Goiter

In the 1960s, with the release of the fifth Italian edition of E. Kaufmann’s, prestigious Trattato di Anatomia Patologica Speciale (Vallardi), edited by Alfonso Giordano, the renown Milanese pathologist, I was amazed (puzzled, to say the least) to read struma in the feminine gender: for years I had been taught the term was masculine (lo struma). Even today, many others (like me) have a predilection for the latter. I satisfied my urge to probe the issue a bit, and found conflicting views. Classic anatomic pathology texts, such as that by A. Pepere A. Businco, or by G. Lanza, as well as more modern volumes like N. Massaioli’s Chirurgia (Minerva Medica) and R. Dionigi’s effort for Masson Editors, not to mention the Italian edition of Churchill’s Medical Dictionary, the term struma is used in the masculine. Italian dictionaries offer little help, seeing that Palazzi’s 2 Edition classifies it in the masculine, while Zingarelli (2002) defines it as a feminine term. Thus, we need to trace the term to its root: in Latin we find struma-strumae, hence, a feminine use. The whole exercise is, we could say, futile. Perhaps both genders can be used. Suffice it to say, however, that the current, above all surgical, use of the term is in the masculine: lo struma. While I was on the subject, I looked into the etymological origins of the word, about which I had already heard (somewhat confusingly) one interpretation that I will cite here, without, however, taking any responsibility. In the Balkans, precisely in Macedonia, the river Struma flows. In Turkish, it goes by the name of Kara-su, the equivalent of Black River. To the ancient Greeks it was Ѕτρύμον, and to the Romans Sinus Strimonicus. Well, legend has it that goiters were particularly prevalent along the banks of this river: hence, the term struma. Putting this diversion aside and getting our feet back on the ground, we can say that struma is synonymous with gozzo (goiter) and, as such, carries the general meaning of enlargement of the thyroid, but also denotes a long enduring benign hyperor dysplasia of the gland.