The First Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province 637000, China.
Institute of Hepato-Biliary-Pancreatic-Intestinal Disease, North Sichuan Medical College, Nanchong, Sichuan Province 637000, China.
J Int Med Res. 2022 May;50(5):3000605221096379. doi: 10.1177/03000605221096379.
A giant cervical goiter, defined as a thyroid mass larger than 8 cm in diameter, is usually a nodular or adenomatous goiter. A giant cervical goiter can also be caused by hyperthyroidism (i.e., Hashimoto's thyroiditis). The surgical indications for patients with Hashimoto's disease include suspected malignant tumors, persistent symptoms related to the disease, or persistent enlargement of the goiter. We herein describe a woman who developed symptoms of compression from a thyroid tumor, the volume of which was almost the largest reported in the relevant literature to date. The bilateral lobes of the giant thyroid tumor were removed by total en bloc excision. We protected the bilateral recurrent laryngeal nerve and preserved the bilateral upper and lower parathyroid glands in situ. The excised left lobe tumor was 16 × 9 × 5.5 cm, whereas the right lobe tumor was 12 × 8 × 4 cm. The pathological diagnosis was Hashimoto's thyroiditis. Although surgical excision is difficult, it is still the main treatment modality for giant goiters in patients with Hashimoto's thyroiditis and can help to reduce the occurrence of complications.
巨大型甲状腺肿定义为直径大于 8 cm 的甲状腺肿块，通常为结节性或腺瘤性甲状腺肿。巨大型甲状腺肿也可由甲状腺功能亢进症（如桥本甲状腺炎）引起。桥本甲状腺炎患者的手术适应证包括疑似恶性肿瘤、与疾病相关的持续症状或甲状腺肿持续增大。我们在此描述了一位因甲状腺肿瘤压迫症状而就诊的女性患者，其肿瘤体积几乎为迄今为止相关文献报道中最大的。采用整块切除法切除了巨大甲状腺肿的双侧叶。我们保护了双侧喉返神经并原位保留了双侧上下甲状旁腺。切除的左侧叶肿瘤为 16×9×5.5 cm，右侧叶肿瘤为 12×8×4 cm。病理诊断为桥本甲状腺炎。尽管手术切除困难，但对于桥本甲状腺炎所致巨大甲状腺肿患者，它仍然是主要的治疗方式，可以帮助减少并发症的发生。
