Large intrathoracic goiter mimicking lung cancer
Kevser Onbasi, Aysen Akalin, Göknur Yorulmaz, Nur Kebapci & Belgin Efe
Herein, we present a case of a 68-year-old woman who had hyperthyroidism and a large mass lesion in the upper portion of her right lung. The patient had a history of previous subtotal thyroidectomy 40 years before. A few years after the operation she noticed some enlargement on her neck. Two years before the admission she was evaluated for some unrelated complaint and a large mass was discovered on her right lung on X-ray examination and she was considered to have a lung cancer at first sight. Tomographic examination revealed a big mediastinal mass of 120×100 mm compressing and deplacing the adjacent structures on the right upper lung region. Biopsy of the lesion was in concordance with thyroid tissue. A scintigraphic evaluation revealed a big thyroid tissue extending from the right thyroid lobe and was in concordance with a large intrathorasic goiter. Her TSH <0.005 μU/ml (N: 0.274.2). FrT3 was 5.65 (N: 2.04.4), and FrT4 was 2.45 ng/ml (N: 0.931.7) and she was thyrotoxic. Despite long-term antithyroid medication at maximal doses she remained in hyperthyroid status. Before surgery plasmapheresis was performed several times in order to achieve an euthyroid status.