Presentation
A known case of toxic goiter with patient on medical treatment for two years without improvement. On a follow-up.
Patient Data
Symmetrically diffusely enlarged thyroid gland lobes with heterohypoechoic echopattern and augmented vascularity. The right lobe measures 57 cc while the left totals 55 cc in volume and each lobe plus the isthmus body demonstrates multiple nodules of increased reflectivity, showing calcific foci of micro-millimeter diameters intrinsically. There is perifocal plus centripetal vascularity within the mentioned thyroid nodules. Small multiple reacted left lateral neck submandibular chain lymph nodes (level III) are noted.
Case Discussion
Diffuse thyromegaly in the background of multinodular accompaniment from both lobes and the isthmus body, the nodules mentioned are overtly suspicious and unanimously with; increased hyper-reflectivity, micro-millimeter calcific foci, irregularly outlined nodular margins and intra-nodular vascularity (TIRADS 4c - moderate suspicion for malignancy). There is bilateral retrosternal extension in this presentation of a clinically known case of toxic goiter.
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