Case Report
A 67-year-old lady presented at the health camp organized in the kihun
village by Bhawana Foundation, Nepal with complaints of Painless neck
swelling for 24 years and shortness of breath since 3 months.. On neck
Examination, huge mass was present more on left side. The mass was
non-tender, non-pulsatile, that moved with deglutition.(Fig. 1)
Thyroid function tests and serum calcium were within normal limits.
Ultrasound of the neck showed multiple nodules and cystic lesions in the
whole gland. The CECT neck revealed heterogeneously enhancing lesions
extending retrosternally.(Fig. 2A and 2B). FNAC suggestive of atypia of
undetermined significance (AUS).
The patient underwent microscopic assisted total thyroidectomy under
general anesthesia. Her post-operative recovery was uneventful and
relieves her shortness of breadth. The patient was discharged on the
sixth postoperative with levothyroxine replacement therapy. The mass
removed from the neck was 461.5 grams and measured approximately 14 cm.
(Fig.3).Microscopic Examination consists with multinodular goitre.
Benign multinodular goiter leading to airway compromise has become a
rare clinical entity. 1Universal salt iodization,
cosmetic concern, and improved surgical technique with minimal
disfigurement have led to the disappearance of monstrous goiter from
modern clinical practice. The definitive management of multinodular
goiter includes total thyroidectomy.2
Acknowledgement: None