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.

Be safe and aware about your health.