A rare case of advanced Thyroid disease operated at KIH
Prof. Brig (Rtd) Asif Asghar -SI(M) (Chest
Surgeon)
What if you hear a patient saying that
while I was sleep, my kids used to judge evidence of life in me from my noisy
laboured breathing. They would rush to see their mother if they did not hear
the sound.
This is a true story of a 55 years female
with a huge enlargement of thyroid for last 25 years. We call it love for
thyroid that she always avoided to get rid of this massive swelling rather she
had custom made clothes to cover her neck. She avoided surgery due to social
stigma and fear. She was brought ultimately by her son for severe noisy
shortness of breath and inability to sleep. We had a diagnosis of airway
narrowing due to massive thyroid extending from ear lobules downwards within
the chest. Her sleep disorder was labelled Sleep Apnea Syndrome due to this
massive swelling. These were the apparent complications due to this goiter but
her family and she never realized the danger of cancer change in the
longstanding thyroid. She was operated in our hospital with minor postoperative
complications. Her final report was negative for cancer. She was discharged on
5th day after surgery with complete resolution of all her symptoms.
What could have been the other outcomes of
this disease?
1. A
significant risk of cancer development especially on longstanding thyroid.
2. In
case of any swelling in neck be it, from respiratory infection or throat
infection she could have choked to
death
as salvage for life as emergency in this patient was impossible.
3. Obstruction
of chest inlet due to massive thyroid.
4. Surgery
in these cases is associated a high risk of death due to choking during airway
control of anesthesia.
How could this be avoided?
The answer is timely treatment, based on
recommendation of treating physician. Although it is never too late for a
decision, you should also strive to search for a safe surgeon, so that you
don’t end up with complications like voice loss, low calcium tetany and
reappearance of Goiter.
This love story had a happy ending but it
is not always like this.