Endocrine Abstracts

JOINT3819

Introduction: The plunging goiter is a rare and atypical form of goiter that extends into the chest, compressing the trachea and esophagus. This results in a variety of symptoms, including respiratory issues (dyspnea, cough) and digestive disturbances (dysphagia). Diagnosis is primarily based on imaging techniques, and treatment options range from medication to surgical intervention. This study aims to investigate the clinical features and therapeutic strategies for plunging goiter.

Objective: To evaluate the clinical presentation, diagnostic procedures, and treatment outcomes of plunging goiter, assessing the effectiveness of medical and surgical interventions in alleviating symptoms and reducing complications.

Patients and Methods: A descriptive study was conducted on 18 patients with plunging goiter admitted to the Endocrinology and Metabolic Diseases Department of Ibn Rochd University Hospital between 01/01/2022 and 20/01/2025.

Results: The study included 18 patients, with a predominance of females (n = 12) and an average age of 58.3 years. Eight patients were from endemic regions. The main presenting symptoms were dysphagia (4 patients), dyspnea (5 patients), dysphonia (1 patient), and signs of thyroid dysfunction (3 patients). Upon physical examination, 5 patients had grade 1 goiter, 6 had grade 2, and 7 had grade 3 goiter. Cervical ultrasound revealed multi-nodular goiters, and signs suggestive of malignancy were found in 4 patients. Chest CT scans performed on all patients confirmed the presence of plunging goiter. Management involved total thyroidectomy in 16 cases, with 2 patients undergoing ultrasound surveillance. Histopathological analysis showed papillary carcinoma in 3 patients and follicular carcinoma in 1. Immediate postoperative complications included cervical hematoma in 1 patient and dysphonia in 2 patients. Monitoring of calcium and phosphate levels post-surgery revealed hypocalcemia in 7 patients, requiring oral calcium supplementation. All patients were placed on thyroid hormone replacement therapy following surgery.

Conclusions: This study supports total thyroidectomy as the treatment of choice for plunging goiter. Continuous follow-up with thyroid hormone replacement therapy is essential for optimal long-term outcomes. Early diagnosis and timely surgical intervention are crucial for preventing complications and improving prognosis.