Division of Clinical Laboratory, Tottori University Hospital, Japan.
Division of Endocrinology and Metabolism, Tottori University Faculty of Medicine, Japan.
Intern Med. 2022 May 1;61(9):1375-1381. doi: 10.2169/internalmedicine.7989-21. Epub 2021 Oct 19.
We describe the clinical course of two patients who developed tracheal compression and deviation by multinodular goiter (MNG). Case 1: A 66-year-old woman presented with thyroid swelling. Five years after the initial admission, she was diagnosed with hyperthyroidism by Graves' disease and increased bilateral thyroid lobes compressing the trachea. Thyroglobulin was elevated from 210 to 472 ng/mL. Case 2: A 52-year-old woman presented with thyroid swelling. Five years after the initial admission, the increased right lobe deviated the trachea and compressed the right recurrent laryngeal nerve. Thyroglobulin was elevated from 122 to 392 ng/mL. Two cases and literature review indicated that MNG with >50 mm, solid components, and extension to the mediastinum or paralarynx were risk factors of tracheal compression and deviation. Monitoring thyroglobulin elevation can help predict the clinical course.
我们描述了两位因多结节性甲状腺肿(MNG)而发生气管受压和移位的患者的临床经过。病例 1:一名 66 岁女性因甲状腺肿大就诊。初次入院 5 年后,她被诊断为 Graves 病伴双侧甲状腺叶增生,压迫气管,导致甲状腺球蛋白从 210ng/ml 升高至 472ng/ml。病例 2:一名 52 岁女性因甲状腺肿大就诊。初次入院 5 年后,右侧叶增大导致气管移位并压迫右侧喉返神经,甲状腺球蛋白从 122ng/ml 升高至 392ng/ml。这两例病例和文献复习表明,直径>50mm、实性成分和向纵隔或旁咽延伸的 MNG 是气管受压和移位的危险因素。监测甲状腺球蛋白升高有助于预测临床病程。