Bocio endotorácico / Endothoracic Goiter

Introducción: Un bocio se considera intratorácico cuando más de un 50 por ciento de la glándula tiroides está en el mediastino, o sea, por debajo del nivel del estrecho torácico superior. Se trata de una enfermedad poco frecuente que padece aproximadamente el 3 por ciento de los pobladores del mundo. La incidencia del bocio nodular ha disminuido debido a la ingestión en algunos países de sal yodada y alimentos ricos en yodo. Esta enfermedad alcanza alrededor del 10 por ciento de las masas mediastínicas. Objetivo: Presentar el caso de un paciente masculino, operado de bocio endotorácico en la provincia de Cienfuegos. Presentación de caso: Se presenta un paciente masculino, de 48 años de edad, que acude a consulta y refiere aumento de volumen del cuello en la región anterior, que se acompaña de decaimiento y en ocasiones disfagia tanto a los alimentos líquidos como a los sólidos. Además, refiere ligera disnea que tolera adecuadamente cuando realiza las actividades de la vida diaria. Por tratarse de una enfermedad poco frecuente, se considera de interés científico publicar el caso para conocimiento de los profesionales dedicados al estudio y tratamiento de las afecciones tiroideas. Conclusiones: El bocio endotorácico es una entidad poco frecuente y en todos los casos requiere de intervención quirúrgica(AU)

Introduction: A goiter is considered intrathoracic when more than 50 percent of the thyroid gland is in the mediastinum; in other words, below the level of the superior thoracic outlet. It is a rare disease that affects approximately 3 percent of the world's population. The incidence of nodular goiter has decreased due to the ingestion of iodized salt and iodine-rich foods in some countries. This disease accounts for about 10 percent of mediastinal masses. Objective: To present the case of a male patient operated on for endothoracic goiter in the province of Cienfuegos. Case presentation: The case is presented of a 48-year-old male patient who comes for consultation referring a volume increase in the anterior neck region, accompanied by decay and sometimes dysphagia to both liquid and solid food. In addition, he reports slight dyspnea that he tolerates adequately when performing daily living activities. Since this is a rare disease, it is considered of scientific interest to publish the case for the knowledge of professionals dedicated to studying and treating thyroid disorders. Conclusions: Endothoracic goiter is a rare entity and, in all cases, requires surgical intervention(AU)

Perforación traqueal diferida tras cirugía tiroidea en un paciente con radioterapia cervical.

Tracheal perforation is a rare complication of thyroid surgery. A 36-year-old man with previous neck radiotherapy due to a nasopharyngeal cancer. After right hemithyoidectomy and isthmusectomy, the patient presented a tracheal perforation. The diagnosis was confirmed with computed tomography and bronchoscopy. A conservative management was performed with drainage and antibiotic therapy, and the evolution was satisfactory. If recognized at the time of the surgery, perforations should be closed primarily. Delayed perforations will be treated with an emergency surgery or conservatively depending on the clinical situation of the patient.

La perforación traqueal es una rara complicación de la cirugía tiroidea. Varón de 36 años con antecedente de radioterapia cervical por una neoplasia de cavum sometido a hemitiroidectomía derecha e istmectomía que durante el posoperatorio presentó una perforación traqueal confirmada por tomografía computarizada y broncoscopia. Se realizó manejo conservador con drenaje y antibioticoterapia, evolucionando de forma favorable. Las perforaciones identificadas durante la cirugía deben ser reparadas intraoperatoriamente, mientras que las diferidas se tratarán de forma quirúrgica urgente o de manera conservadora en función de la situación clínica del paciente.

Caracterización y manejo del nódulo tiroideo en niños, en el Servicio de Cirugía de Cabeza, Cuello y Máxilo Facial del Instituto Nacional de Salud del Niño - Breña, 2000 - 2020 / Characterization and management of the thyroid nodule in children, in the Head, Neck and Maxillo facial Surgery Service of the Instituto Nacional de Salud del Niño - Breña, 2000 - 2020

RESUMEN Introducción. El nódulo tiroideo en niños generalmente es asintomático, de presentación múltiple y aislada, con dificultad para instaurar el riesgo de malignidad, sobre todo si no es palpable. Objetivo. Determinar las características epidemiológicas, clínicas, ecográficas y manejo quirúrgico del nódulo tiroideo en pacientes del Servicio de Cirugía de Cabeza, Cuello y Máxilo Facial del Instituto Nacional de Salud del Niño (INSN) - Breña, 2000 -2020. Métodos. Estudio observacional, descriptivo y retrospectivo. Se usó la clasificación Bethesda para los estudios citológicos. Los datos fueron analizados en el programa SPSS versión 22. Las variables cualitativas fueron expresadas en frecuencias absolutas y relativas; y las cuantitativas en medidas de tendencia central y dispersión. Resultados. Fueron 66 casos, el promedio de edad fue 10,94 ± 0,88 años, el 48,5% entre 11 a 15 años, el 78,8% fueron del sexo femenino, un 89,4% no referían antecedente familiar de cáncer. Predominó la forma asintomática (74,2%). Ecográficamente el 43,9% de nódulos se localizaron en lóbulo derecho, presentación única (68,2%) y menor a dos centímetros (43,9%). El 82,6% de los 23 casos Bethesda II fueron hemitiroidectomizados y el 86,4% de 22 casos Bethesda VI fueron tiroidectomizados. Conclusiones. En pacientes pediátricos, los nódulos tiroideos se presentaron mayormente en mujeres de 11 a 15 años, sin antecedente familiar de cáncer, asintomáticos, localizados en lóbulo derecho, únicos y menor a dos centímetros. El grado II de la clasificación Bethesda fue la más frecuente. La hemitiroidectomía fue la intervención quirúrgica más utilizada.

ABSTRACT Introduction. The thyroid nodule in children is usually asymptomatic, multiple and isolated presentation, with difficulty in establishing the risk of malignancy, especially if it is not palpable. Objective. To determine the epidemiological, clinical and ultrasound characteristics and surgical management of thyroid nodules in patients of the Head, Neck and Maxillofacial Surgery Service of the Instituto Nacional de Salud del Niño (INSN) - Breña, 2000-2020. Methods. Observational, descriptive and retrospective study. The Bethesda classification was used for cytological studies. Qualitative variables were expressed in absolute and relative frequencies; and quantitative variables in measures of central tendency and dispersion. Results. There were 66 cases, the average age was 10.94 ± 0.88 years, 48.5% between 11 and 15 years, 78.8% were female, 89.4% had no family history of cancer. The asymptomatic form predominated (74.2%). Ultrasonographically, 43.9% of nodules were located in the right lobe, single presentation (68.2%) and smaller than two centimeters (43.9%). 82.6% of the 23 Bethesda II cases were hemithyroidectomized and 86.4% of 22 Bethesda VI cases were thyroidectomized. Conclusions. In pediatric patients, thyroid nodules occurred mostly in women aged 11 to 15 years, with no family history of cancer, asymptomatic, located in the right lobe, single and less than two centimeters. Grade II of the Bethesda classification was the most frequent. Hemithyroidectomy was the most used surgical intervention

Bocio endotorácico en un adulto / Endothoracic goiter in an adult

Se presenta el caso clínico de un paciente de 48 años de edad, quien acudió a la consulta de Patología de Tiroides del Hospital Provincial Dr. Gustavo Aldereguía Lima de Cienfuegos, por presentar aumento de volumen del cuello en la región anterior, decaimiento, ocasionalmente disfagia y ligera disnea. Al examen físico se constató un tumor en la región anteroinferior y lateral derecha del cuello, movible, que se prolongaba hacia abajo a la parte superior del tórax. Se realizó hemitiroidectomía derecha con exéresis de la prolongación endotorácica. El paciente evolucionó favorablemente.

The case report of a 48 years patient is presented. He went to the Thyroid Pathology Service of Dr. Gustavo Aldereguía Lima Provincial Hospital from Cienfuegos, due to an increase of volume in the anterior region of the neck, weakness, occasionally deglutition disorders and light dyspnea. A tumor was verified in the anteroinferior and lateral right region of the neck, movable, that was prolonged downward to the superior part of the thorax when the physical exam was carried out. A right hemithyroidectomy was carried out with exeresis of the endothoracic extension. The patient had a favorable clinical course.

Incidence and predictive factors of postoperative hypocalcaemia according to type of thyroid surgery in older adults.

PURPOSE: Transient hypocalcaemia after thyroid surgery and its possible predictors have not been extensively described in the elderly. This study aimed to establish the frequency of postsurgical transient hypocalcaemia according to the extent of thyroid surgery in older adults and to assess mineral metabolism biochemical parameters as its predictors. METHODS: All patients ≥60 years undergoing thyroid surgery were prospectively included. Type of surgery (hemithyroidectomy(HT) or total thyroidectomy(TT)); and preoperative 25OH Vitamin D (25OHD) and pre and 6 (only TT), 24 h and 6 months postsurgical serum levels of calcium, magnesium, phosphate and parathormone (PTH) were considered. Postsurgical hypoparathyroidism (hPTpost) was defined at PTH levels ≤11 pg/mL. RESULTS: Out of 46 patients (87% female), age (mean ± SD) 70.1 ± 6.2 years, 24 h postsurgical hypocalcaemia was found in ten patients (22%). In 25 (54%) TT patients, 36% and 16% had postsurgical hypocalcaemia at 6 and 24 h respectively; 28% hPTpost but no definitive hPT was recorded and 44% had 25OHD deficiency. Lower 24 h magnesium levels were found in those TT patients with 24 h hypocalcaemia (1.6 ± 0.1 vs 1.9 ± 0.1 mg/dL (p = 0.005)). Among 21 (46%) HT patients, 28.6% had 24 h postsurgical hypocalcaemia; 9.5% had hPTpost. A positive correlation was observed between preoperative 25OHD and 24 h calcaemia (r:0.51,p = 0.02). 43% of the patients were 25OHD deficient, in whom 55% had 24 h hypocalcaemia vs only 9% in the 25OHD sufficient group (p = 0.049). CONCLUSION: Postsurgical hypocalcaemia was common in elderly thyroidectomized patients. After TT, lower magnesium levels were found in those patients with 24 h hypocalcaemia. In the HT group, preoperative 25OHD deficiency predicted lower postsurgical calcium levels.

Hemitireoidectomia por carcinoma em equino / Equine carcinoma hemithyroidectomy

Background: In horses, the thyroid gland is located slightly caudal to the larynx and dorsolaterally between the third and sixth tracheal ring, adjacent to the thyroid, there are four small glands called parathyroid glands. In the clinical routine of horses, thyropathies are difficult to be diagnosed, as they have a silent evolution. Thyroid neoplasia is the most common finding in horses, usually unilateral and normally present in older animals. The present study reports a case of equine thyroid carcinoma and its systemic clinical effects, which was successfully treated by means of hemitieroidectomy. Case: A 12-year-old male mixed breed horse weighing 436 kg, was admitted to the Veterinary Medical Teaching Hospital of the FZEA/USP with the main complaint of volume increase in the right ventrolateral region of the neck, difficulty in swallowing, significant weight loss and weakness of the pelvic limbs. On inspection, there was an increase in volume in the topographic region of the thyroid gland and on palpation, there was a firm mass, with delimited edges, with a smooth, mobile surface, without increasing the temperature and without pain. The animal was sent for ultrasound examination, which revealed a delimited mass, with an apparent capsule around it, differentiated and disorganized cellularity with small hypoechoic points of liquid inside the structure, with no apparent vascularization inside the mass. These findings, associated with the anatomical location of the mass, were consistent with thyroid tissue. The clinical signs commonly observed in thyroid neoformations are respiratory stridor, decreased performance, difficulty in swallowing and suffocation. As there was a compromised diet and weight gain, as well as athletic performance, he chose to have a hemithyroidectomy. After surgery, histopathology of the tissue was performed and thyroid carcinoma was diagnosed. Postoperatively, the animal was medicated with antibiotics, anti-inflammatory and anti-tetanus serum, after 10 days the stitches were removed and the animal was discharged. Discussion: Neoplasia is the most frequent cause of progressive thyroid growth and in case of suspicion of thyroid disorders, thin needle aspiration (FNAB) is recommended and, later, histopathological examination, which is considered the gold standard for diagnosis pathologies of the thyroid gland. In the present case, no FNAB or preoperative histopathological examination was performed due to the time required to obtain the result, associated with difficulty in swallowing and significant weight loss, which required immediate removal of the mass. Considering that the ultrasound examination revealed the absence of noble structures or important vascularization very close to or adhered to the mass, its removal prior to the histopathological examination was indicated. As there was compromised feeding and weight gain, he opted for hemithyroidectomy, the recommended treatment for unilateral tumors in horses. When performing a hemithyroidectomy, it should be remembered that the parathyroid glands accompany the thyroid and are located in its posterior portion, in the pre tracheal region, with its variable final position. With this variation in topography, the identification of parathyroid glands becomes challenging and, consequently, after thyroidectomy, a portion of parathyroid glands stops operating, and this fact is marked clinically by hypocalcemia and its consequences. In this case described, in which the animal had a tumor in thyroid tissue, possibly the parathyroid functions were also altered, which probably reflected in the lameness in the pelvic limbs. It is concluded that partial hemithyroidectomy in horses is an easy procedure to perform and has favorable results in relation to prognosis and quality of life.

Cirugía mayor ambulatoria de la glándula tiroides y paratiroides: resultados tras 6 años de experiencia / Major outpatient surgery of the thyroid and parathyroid glands: results after 6 years experience

Objetivo: La cirugía mayor ambulatoria (CMA) y con estancia inferior a 24 horas (overnight stay) se ha consolidado en muchas patologías aunque en cirugía tiroidea y paratiroidea resulta controvertido. El objetivo es valorar nuestros resultados en cirugía del tiroides y paratiroides en régimen de CMA durante un periodo de 6 años. Material y Métodos: Estudio observacional prospectivo de pacientes con indicación de hemitiroidectomía o paratiroidectomía enfocada en régimen CMA entre enero de 2011 y diciembre de 2016. Los pacientes cumplían criterios de CMA. En los primeros años se excluyeron los nodulos tiroideos mayores de 3 cm y los pacientes ASA III. Los pacientes ingresaron la mañana de la intervención, tras el acto quirúrgico pasaron a la Unidad de Recuperación Posquirúrgica y posteriormente a sala de hospitalización. Tras 8 h, si cumplían criterios, fueron dados de alta. Resultados: Se intervinieron 270 pacientes, la tasa de aplicabilidad global fue del 59%, la tasa de aceptabilidad global del 83,6% y el índice de sustitución del 49,2%. El índice de ingresos no deseados fue del 10,4% para la paratiroidectomía y del 17,6% en la cirugía del tiroides. Ningún paciente presentó complicaciones mayores en su domicilio. El grado de satisfacción fue alto o muy alto en el 94% de los pacientes. Conclusiones: La paratiroidectomía enfocada y la hemitiroidectomía realizada por cirujanos expertos en pacientes seleccionados, es segura y efectiva en régimen ambulatorio. Es posible mejorar el índice de sustitución ambulatorio aumentando la tasa de aplicabilidad y aceptabilidad.

Objetive: Ambulatory or overnight stay surgery have been consolidated in many different procedures. However, its use in thyroid and parathyroid surgery is still controversial. The aim of this report is to present the results of 6 years of ambulatory patients undergoing surgery of the thyroid or parathyroid glands. Material and Methods: Prospective observational study of patients who underwent hemithyroidectomy or selective parathyroidectomy in the ambulatory program from January 2011 to December 2016. All patients included met the general criteria of ambulatory surgery. During the first years nodules bigger than 3 cm and patients classified as ASA III were excluded. Patients arrive at hospital the morning of surgery. After the operation, patients pass to the post-anesthesia care unit and then to the hospitalization room. 8 hours after surgery patients are discharged home if they meet the criteria. Results: 270 patients were operated, 159 of them met the inclusion criteria. The overall applicability rate was 59%. The acceptance rate was 83.6% and the substitution index was 49.2%. The unwanted hospital admission was 10.4% for the parathyroidectomy and 17.6% for the hemithyroidectomy. Any patient presented major complications at home. The satisfaction rate was high or very high for 94% of the patients. Conclusion: Selective parathyroidectomy and hemithyroidectomy performed by experienced surgeons in selected patients can be safely and effectively carried out in ambulatory surgery (outpatient). It would be possible to improve the substitution index by increasing the application and acceptability ratios.

Bocio endotorácico / Endothoracic goiter

Paciente masculino de 64 años de edad con antecedentes de hipertensión arterial y alergia al yodo, tratado con enalapril, que acudió a Consulta de Medicina Interna del Policlínico Máximo Gómez Báez de Holguín en enero de 2016 por presentar decaimiento, cansancio fácil, tos seca frecuente, palpitaciones, disfagia y cambios de la voz (ronquera), cuadro que comenzó hacía aproximadamente dos meses, y fue aumentando en intensidad sin otras complicaciones. Se realizaron los estudios de laboratorio para la valoración preoperatoria, además de los estudios de la función tiroidea, radiografías de tórax (vista antero posterior y lateral), tomografía de tórax, ecografía de la tiroides y biopsia de aspiración con aguja fina en el Hospital Clínico Quirúrgico Lucía Íñiguez de Holguín. Se encontró un bocio endotorácico y se realizó tratamiento quirúrgico que consistió en hemitiroidectomía derecha. El transoperatorio y el posoperatorio transcurrieron sin complicaciones, y el informe anatomopatológico reveló la presencia de un bocio coloide adenomatoso.

A 64-year-old male patient with a history of hypertension and iodine allergy, treated with enalapril, who came to the Internal Medicine Consultation of Máximo Gómez Báez Polyclinic in Holguín in January 2016 due to decay, easy fatigue, frequent dry cough, Palpitations, dysphagia and voice changes (hoarseness), a condition that began about two months ago, and increased in intensity without other complications. Laboratory studies were performed for preoperative assessment, in addition to studies of thyroid function, chest X-rays (anteroposterior and lateral view), chest x-ray, thyroid ultrasound, and fine needle aspiration biopsy at Lucía Íñiguez Clinical l Surgical Hospital of Holguín. An endothoracic goiter was found and surgical treatment consisted of right hemithyroidectomy. The transoperative and the postoperative period passed without complications, and the anatomopathological report revealed the presence of an adenomatous coloid goiter.

Observaciones críticas en torno a las afecciones nodulares de tiroide / Critical observations on the nodular disorders of thyroid

El nódulo del tiroides es frecuente tanto en la práctica clínica como en la quirúrgica. El tratamiento que ofrece mejores posibilidades parece ser la hemitiroidectomía para tumores unilaterales benignos y la tiroidectomía total para los malignos, con linfadenectomía en caso de metástasis ganglionares; operaciones con poca morbilidad cuando son realizadas por cirujanos experimentados. El tratamiento supresivo posquirúrgico con hormonas tiroideas es capaz de detener la progresión tumoral, inducir la regresión de metástasis y aumentar la supervivencia. Por otra parte, en los tumores recurrentes y metastáticos que no capten yodo se utilizan la radioterapia externa y la quimioterapia adyuvante. Considerando que las neoplasias tiroideas malignas son potencialmente curables y libres de secuelas, en el presente artículo se exponen algunos criterios al respecto...

The thyroid nodule is frequent in the clinical practice as in the surgical one. The treatment offering better possibilities seems to be hemithyroidectomy for benign unilateral tumours and total thyroidectomy for malignancies, with lymphadenectomy in case of ganglion metastasis; which are surgeries with little morbidity when carried out by experienced surgeons. The postsurgical suppressive treatment with thyroid hormones can stop the tumorous progress, can induce the metastasis regression and can increase survival. On the other hand, in the recurrent and metastatic tumours which fix no iodine, the external radiotherapy and the auxiliary chemotherapy are used. Taking into account that thyroid malignant neoplasias are potentially curable and free of sequels, some approaches are exposed on this respect in this work...

Hiperplasia paratiroidea ectópica de doble localización, intratiroidea e intratorácica / Double ectopic parathyroid hyperplasia, intrathyroidal and intrathoracic

Se presenta el caso de una paciente sometida satisfactoriamente a hemitiroidectomía izquierda por diagnóstico de bocio nodular. El estudio anátomo-patológico de la pieza operatoria informó que el aumento de tamaño del lóbulo tiroideo izquierdo se debía a glándula paratiroides hiperplásica intratiroidea. Con este resultado se solicitó gammagrafía paratiroidea, en la que se encontró un área de captación en la región torácica derecha. Se concluyó que se trató de hiperplasia paratiroidea ectópica de doble localización, intratiroidea e intratorácica.

The case of a patient who satisfactorily underwent left hemithyroidectomy for nodular goiter is reported. Pathology study of the specimen stated enlarged left thyroid gland lobe due to hyperplasic intrathyroidal parathyroid. With this result parathyroid gammagraphy was obtained and a right thoracic capture area was reported. Final diagnosis was ectopic parathyroid hyperplasia of double localization, intrathoracic and intrathyroidal.

Comportamiento de la enfermedad nodular del tiroides en el Servicio de Cirugía General del Hospital Vladimir Iich Lenin de Holguín / Behavior of Thyroid Nodular Disease in General Surgery Service in Vladimir Ilich Lenin Hospital of Holguin

Introducción: la enfermedad nodular de la glándula tiroides es causa frecuente de atención en las consultas externas de los servicios de salud. Por esta razón, es importante conocer sus formas fundamentales de presentación, los exámenes complementarios necesarios para su diagnóstico y el seguimiento establecido para vigilar su evolución. Objetivo: caracterizar el comportamiento de la enfermedad nodular de la glándula tiroides en pacientes atendidos en el Servicio de Cirugía General del Hospital General Universitario Vladimir Ilich Lenin de la provincia Holguín. Métodos: se realizó un estudio descriptivo en pacientes con enfermedad nodular de la glándula tiroides atendidos en el Servicio de Cirugía General del Hospital General Universitario Vladimir Ilich Lenin de la provincia Holguín. El universo estuvo constituido por 931 pacientes que acudieron a consulta, la muestra estuvo constituida por 423 pacientes que padecían enfermedad nodular de la tiroides. Resultados: predominó el sexo femenino, así como, las edades entre 31 y 45 años. El aumento de volumen en la región anterior del cuello fue el motivo de consulta más frecuente. Como enfermedad asociada predominó la hipertensión arterial. El carcinoma papilar fue el más encontrado en los nódulos malignos. Prevalecieron los nódulos mayores de 15 mm para el lóbulo, únicos, unilaterales, de bordes regulares y contenido líquido con ganglios múltiples y calcificaciones. El lóbulo izquierdo fue el más afectado. En todos los pacientes se confirmó el diagnóstico mediante ecografía. Predominó el diagnóstico histológico no maligno de la glándula extirpada. Conclusiones: la hemitiroidectomía izquierda con istmectomía fue la resección más frecuente, sin accidentes quirúrgicos y evolución postoperatoria satisfactoria. La complicación más evidente en la cirugía tiroidea fue la disfonía transitoria y como secuela los queloides de la herida quirúrgica.

Introduction: nodular disease of the thyroid gland is a frequent cause of care in outpatient health services, so it is important to know the key features of presentation, any further examination and established monitoring. Objective: to characterize the nodular disease of the thyroid gland behavior in patients attended at General Surgery Service of Vladimir Ilich Lenin Hospital of Holguin. Methods: a descriptive study in patients with nodular thyroid gland, at General Surgery Service of Vladimir Ilich Lenin Hospital. The universe comprised 931 patients and 423 of them represented the sample. Results: papillary carcinoma was the most malignant one found. Nodules of more than 15 mm, unique, unilateral, of regular brink with liquid and multiple ganglia and calcification prevailed. The left lobule was the most affected one. The diagnosis was confirmed in all patients through echography. Non- malignant histologic removed gland predominated Conclusions: the left hemithyroidectomy with isthmectomy was the most frequent resection without postoperative surgical accidents and satisfactory progress. The most obvious complication in thyroid surgery was transient dysphonia as keloids sequel of the surgical wound.

Bocio endotorácico / Endothoracic goiter

Se informa el caso de una paciente de 71 años de edad, con antecedentes de hipertensión arterial, que acude a consulta externa pues hace unos 5 años presenta aumento de volumen de la región inferior y lateral del cuello que se acompaña de decaimientos, palpitaciones y disfagia ocasional. Se realizaron los estudios de laboratorio para la valoración preoperatoria, además de los estudios de la función tiroidea, radiografías de tórax (vista anteroposterior), tomografía de tórax, ecografía de la tiroides y biopsia de aspiración con aguja fina. Se encontró un bocio endotorácico eutiroideo y se realizó tratamiento quirúrgico que consistió en hemitiroidectomía izquierda con istmectomía. El transoperatorio y el posoperatorio transcurrieron sin complicaciones, y el informe anatomopatológico reveló la presencia de un bocio coloide nodular(AU)

This is the case of a female patient aged 71 with a history of high blood pressure seen in external consultation since five years ago she presents a volume increase of lower and lateral region of the neck accompanied of weakness, palpitations and occasional dysphagia. Laboratory studies were conducted to preoperative assessment in addition to thyroid function studies, thorax X-rays (anteroposterior view), thorax tomography, thyroid gland echography and fine needle aspiration biopsy (FNAB). A euthyroid endothoracic goiter was present; surgical treatment was done consisting of left hemithyroidectomy with isthmectomy. In transoperative and postoperative periods there were not complications and the anatomic and pathologic report revealed the presence of nodular colloid goiter(AU)

Bocio endotorácico / Endothoracic goiter

Se informa el caso de una paciente de 71 años de edad, con antecedentes de hipertensión arterial, que acude a consulta externa pues hace unos 5 años presenta aumento de volumen de la región inferior y lateral del cuello que se acompaña de decaimientos, palpitaciones y disfagia ocasional. Se realizaron los estudios de laboratorio para la valoración preoperatoria, además de los estudios de la función tiroidea, radiografías de tórax (vista anteroposterior), tomografía de tórax, ecografía de la tiroides y biopsia de aspiración con aguja fina. Se encontró un bocio endotorácico eutiroideo y se realizó tratamiento quirúrgico que consistió en hemitiroidectomía izquierda con istmectomía. El transoperatorio y el posoperatorio transcurrieron sin complicaciones, y el informe anatomopatológico reveló la presencia de un bocio coloide nodular(AU)

This is the case of a female patient aged 71 with a history of high blood pressure seen in external consultation since five years ago she presents a volume increase of lower and lateral region of the neck accompanied of weakness, palpitations and occasional dysphagia. Laboratory studies were conducted to preoperative assessment in addition to thyroid function studies, thorax X-rays (anteroposterior view), thorax tomography, thyroid gland echography and fine needle aspiration biopsy (FNAB). A euthyroid endothoracic goiter was present; surgical treatment was done consisting of left hemithyroidectomy with isthmectomy. In transoperative and postoperative periods there were not complications and the anatomic and pathologic report revealed the presence of nodular colloid goiter(AU)