Giant multinodular goiter: clinical case

Authors

DOI:

https://doi.org/10.26641/1997-9665.2025.2.47-53

Keywords:

thyroid gland; giant goiter; multinodular goiter; ultrasonography; computed tomography; total thyroidectomy; individualized approach

Abstract

Relevance. Giant multinodular goiter (GMNG) is a serious clinical problem due to the risk of airway compression, marked cosmetic defect, and possible extension into the thoracic cavity. Aim. To analyze a clinical case of a patient with a giant multinodular goiter. Case description. Patient X, 75 years old, presented with marked neck deformity and mild dyspnea. She considered herself ill for 7 years after noting anterior neck contour changes due to a prominent mass. She had not sought medical attention. During the last four months the mass enlarged significantly. Results and conclusion. The patient had concomitant hypertension. Laboratory values were within reference ranges. Thyroid hormone levels were normal. The thyroid gland was enlarged to grade II, mainly due to the right lobe, where a mobile elastic nodule measuring 150 mm was palpated. Ultrasound findings: The thyroid gland was in a typical location. The left lobe contained multiple small colloid nodules; the right lobe, extending to the isthmus and leftward, was occupied by a heterogeneous nodule measuring 200 × 150 mm. No enlarged or pathologically altered lymph nodes were detected. CT findings: Along the right side of the neck a massive lesion with smooth, well‑defined margins and heterogeneous density displaced and compressed the trachea. The upper pole reached the mandibular angle, and the lower pole reached the right clavicle. A connection with the right thyroid lobe was visualised. Diagnosis: Giant multinodular goiter. An elective fine‑needle aspiration evacuated about 1 500 mL of content (lysed blood) from the nodule, followed by thyroidectomy. Histopathology: Nodular colloid goiter. This clinical case corresponds to data in the medical literature regarding the predominance of GMNG in elderly women and the high informative value of imaging modalities in this pathology. Giant multinodular goiter is a complex clinical challenge requiring early recognition, accurate imaging, and skilled surgical management to prevent life‑threatening complications. Total thyroidectomy performed in accordance with current AAES guidelines and adapted to distorted anatomy provides low recurrence rates and acceptable morbidity. Future studies should focus on improving access to modern imaging and surgical resources in underserved regions and on long‑term functional outcomes, including quality of life and thyroid‑hormone‑related consequences.

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Published

2025-07-30

How to Cite

Skaletskyi , M., Masna , Z., & Lopushanska , H. (2025). Giant multinodular goiter: clinical case. Морфологія / Morphologia / Morfologìâ, 19(2), 47–53. https://doi.org/10.26641/1997-9665.2025.2.47-53

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Vol. 19 No. 2 (2025)

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