title: Acute airway obstruction due to benign asymptomatic nodular goiter in the cervical region: A case report.
abstract: Benign nodular goiter is a common disease. Although large goiters with obstructive symptoms including shortness of breath and dyspnea are a clear indication for surgery, acute upper airway obstruction, particularly in benign cervical goiter cases, is rare. We herein report the case of 46-year-old female with acute upper airway obstruction due to benign nodular goiter. The patient had a large and elastic goiter which was more pronounced on the left side of her neck, and surgery was scheduled for within a few months. Three months after the initial presentation, while still waiting for surgery, the patient was brought to the emergency room due to loss of consciousness and breathing difficulty and was immediately intubated. A computed tomography (CT) scan revealed that the trachea was markedly compressed by a nodular lesion in the left lobe, and bilateral pneumonia was also evident. Total thyroidectomy was immediately performed via the supraclavicular approach. The patient had an uneventful postoperative course and recovered well. The resected specimen included a well-encapsulated solid and cystic mass. Histopathological examination mainly revealed adenomatous goiter. The present case suggests that benign asymptomatic nodular goiter mostly located in the neck may cause acute airway obstruction, even if the nodules are not large. Early surgery should be performed when tracheal deviation and stenosis due to a large goiter is prominent by CT scan.
authors.affiliation: Division of Breast and Endocrine Surgery, Iida Municipal Hospital, Iida, Nagano 395-8502, Japan.
authors.forename: Tokiko
authors.initials: T
authors.lastname: Ito
authors.affiliation: Division of Breast and Endocrine Surgery, Iida Municipal Hospital, Iida, Nagano 395-8502, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Shingu
authors.affiliation: Division of Breast and Endocrine Surgery, Iida Municipal Hospital, Iida, Nagano 395-8502, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Maeda
authors.affiliation: Division of Breast and Endocrine Surgery, Iida Municipal Hospital, Iida, Nagano 395-8502, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Kitazawa
authors.affiliation: Division of Breast and Endocrine Surgery, Iida Municipal Hospital, Iida, Nagano 395-8502, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Mizukami
authors.affiliation: Division of Breast and Endocrine Surgery, Iida Municipal Hospital, Iida, Nagano 395-8502, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Hiraguri
authors.affiliation: Division of Breast and Endocrine Surgery, Iida Municipal Hospital, Iida, Nagano 395-8502, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Horigome
authors.affiliation: Division of Breast and Endocrine Surgery, Iida Municipal Hospital, Iida, Nagano 395-8502, Japan.
authors.forename: Gengo
authors.initials: G
authors.lastname: Kaneko
authors.affiliation: Division of Breast and Endocrine Surgery, Iida Municipal Hospital, Iida, Nagano 395-8502, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Itoh
authors.affiliation: Division of Breast and Endocrine Surgery, Iida Municipal Hospital, Iida, Nagano 395-8502, Japan.
authors.forename: Ken-Ichi
authors.initials: KI
authors.lastname: Ito
keywords: acute airway obstruction; adenomatous goiter