Objective: To present an unusual case of a goitre co-existing with bilateral thryoglossal fistula.
Introduction: AF, a 32-year-old male presented with 4 years history of an anterior neck swelling associated with palpitations, heat intolerance, protrusion of the eyeballs, weight loss, tremors of the hands and generalized weakness.
Prior to onset of the neck swelling, he had noticed since childhood that whenever he drinks any fluid, some of the fluid drips out from two points on either side of the lower part of his neck. No associated history of neck pain, no family history of thyroid disease. No associated ear or nasal symptoms.
Examination: Young man with thyroid stare, bilateral proptosis, diaphoretic, with tremors of the outstretched hands and warm and moist palms. Neck: anterior neck mass about 80 g in size, with scarification marks, soft, non-nodular, non-tender, with discharge of clear fluid from the inferior region bilaterally. CVS: pulse rate 104 beats per minute, Blood pressure 120/70 mmHg. Precordium was hyperactive. Cardiac apex was not displaced. First and second heart sounds were heard.
Assessment: Toxic Goitre co-existing with bilateral thyroglossal fistula.
Results: Ultrasound: diffuse goiter. No nodule or cyst demonstrated. Thyroid function test:
He was commenced on anti-thyroid medications and is scheduled for Fistulography.