Severe Trachea Compression: A Rare Presentation of Giant Intrathoracic Goiter with Papillary Thyroid Cancer

Thyroid goiter is a common endocrine abnormality that is typically asymptomatic. However, giant intrathoracic thyroid goiter may compress the trachea and esophagus and result in clinical symptoms such as dyspnea or dysphagia, without any remarkable changes in the external appearance of the neck. Without detailed imaging examination, patients may be misdiagnosed with pulmonary or cardiovascular disease. In this study, we present the case of a 49-year-old male patient who visited our hospital due to high-pitched breathing sounds and dyspnea that had persisted for months. Imaging examination revealed a giant intrathoracic goiter severely compressing the trachea, which was surgically removed through a neck incision without complications. The intrathoracic goiter was sized approximately 15.5 × 7.5 × 5.5 cm, and was combined with a papillary carcinoma of approximately 1.5 cm, which was pathologically diagnosed. The patient's symptoms were completely relieved after the operation. There was no recurrent laryngeal nerve injury, and the patient remained free of recurrence and metastasis during the 12 months of follow-up.

關鍵字

thyroid goiter ； papillary thyroid cancer ； trachea compression

並列摘要

甲狀腺腫是一種常見且大多無症狀的內分泌腺疾病，但是當甲狀腺過度腫大並延伸入胸腔時就可能壓迫氣管及食道，進而引起呼吸困難或吞嚥困難等臨床症狀。當病人來院時頸部外觀上無明顯異常又缺乏影像協助診斷時，病患可能會被誤認為心肺或其他內科疾病。本個案報告一49歲男性因為連續數月的高頻呼吸音及呼吸困難而來醫院就診，其頸部外觀無明顯異常，而影像顯示一個巨大的胸腔內甲狀腺腫造成氣管嚴重的壓迫。我們將甲狀腺腫經由頸部切口移除，標本大小約15.5 × 7.5 × 5.5公分，內含有一1.5公分大的甲狀腺乳突癌。術後病人的臨床症狀完全消失，且無喉返神經損傷。術後已追蹤達12個月，尚未發現復發或遠端轉移的證據。

並列關鍵字

甲狀腺腫；甲狀腺乳突癌；氣管壓迫

國際替代計量

Severe Trachea Compression: A Rare Presentation of Giant Intrathoracic Goiter with Papillary Thyroid Cancer

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