Fulminant progressive thyroid cyst with tracheal compression – a case report

• Published in: Experimental and Clinical Endocrinology & Diabetes
• Main Authors: Pasieka, M, Thavarajah, S, Adamzik, M, Paul, A, Weber, F, Lahner, H
• Format: Conference Proceeding
• Language: English
• Published: 07.03.2013
• ISSN: 0947-7349; 1439-3646
• DOI: 10.1055/s-0033-1336715

Aims: Thyroidal cysts are common, but a massive enlargement leading to acute respiratory insufficiency is rare. Case report: We report a 55 year old female patient presenting with progressive stridor and respiratory insufficiency leading to urgent need for intubation. Thoracic CT showed a massive enlargement of the thyroid gland with tracheal compression. Blood test results indicated normal thyroid function, but elevated infection parameters. Fine needle aspiration (FNA) showed a brownish, spumy fluid. In microbiological analysis presence of staphylococcus species was detected, which was verified by PCR. Altogether, the results suggested a thyroidal abscess. Promptly surgical intervention finally revealed goiter with a macro cyst, without evidence for an inflammatory process. Subtotal thyroidectomy was performed, followed by an unremarkable course with patient's discharge after 6 days. Conclusion: Causes for tracheal compression near the thyroid gland can be abscesses, benign and malignant thyroid tumors as well as hematomas after FNA or trauma. In our case, a thyroidal cyst led to an acute respiratory emergency.