Tsunoda T, Mochinaga N, Eto T, Terada M, Tsuchiya R
Second Department of Surgery, Nagasaki University School of Medicine, Japan.
Jpn J Surg. 1991 Jul;21(4):450-3. doi: 10.1007/BF02470974.
A extremely rare case of Hashimoto's thyroiditis presenting with pressure symptoms is described herein. A 50 year old Japanese woman was referred to our department with swelling of the anterior neck, facial edema and recent heavy snoring. Oto-rhinolaryngological examinations revealed no movement of the bilateral vocal cords, severe laryngeal edema and diffuse edema of the tongue and pharynx. These findings had apparently been induced by compression of the bilateral recurrent nerves and internal jugular veins by an enlarged thyroid gland. The results of thyroid function and autoimmune tests were compatible with a diagnosis of Hashimoto's disease and thus, total thyroidectomy with a tracheostomy was performed uneventfully. The resected specimen weighed 168 grams and was confirmed histologically to be Hashimoto's disease. Following her operation, all the above symptoms disappeared and 4 months later, the patient is well and asymptomatic.
本文描述了一例极为罕见的伴有压迫症状的桥本甲状腺炎病例。一名50岁的日本女性因前颈部肿胀、面部水肿及近期严重打鼾被转诊至我科。耳鼻喉科检查发现双侧声带无活动、严重喉水肿以及舌和咽部弥漫性水肿。这些表现显然是由肿大的甲状腺压迫双侧喉返神经和颈内静脉所致。甲状腺功能及自身免疫检查结果符合桥本氏病的诊断，因此，顺利进行了全甲状腺切除术并施行气管切开术。切除标本重168克，组织学检查证实为桥本氏病。术后，上述所有症状均消失，4个月后，患者情况良好且无症状。
