<prompt> The most common presentation of endemic goiter isHypothyroidDiffuse goiterHypehyroidSolitary nodule  <response>: Answer is B Diffuse Goiter : Euthyroid state is generally the rule - Robbins Endemic goiter :occurs in geographical areas where the soil, water and food supply contains only low levels of iodine. The lack of the iodine leads to decreased synthesis of thyroid hormones and a compensatory increase in TSH, which in turn leads to follicular cell hyperophy and hyperplasia and goitrous enlargement - Diffuse hyperplastic goitre. Euthyroid state is generally the rule Rare patients are hypehyroid 