final cp thyroid
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Case Presentation
A 40 year old male presenting with anteneck swelling for 3 months
Presented by Dr Sovit
Moderated by Dr Sorabha
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Patient details
• !ame" #a$ %mar
• Age&Se'" 40 yr&male
• Address" (arwala) *aryana
•
C# !o+" ,0-303./,///
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Chief Complaint
•Swelling in front of lower neck for 3 m
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Case Smmary
Patient #a$ %mar 40yr&Male )from (arwala) presented to !1 2PD with complaint of swellianterior neck for 3 months which was insidios ingradally progressive+ !ot a&w h&o diclty in deor noisy breathing or dyspnea on e'ertion) chvoice) any symptoms of hypo or hyper thyroidwith no sggestive past or family history) previos history of radiation) chronic drg intaketaboo or food likes+
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2&
• .56 cm 7rm) mobile) non tender) non plsatile) well d
globlar swelling on t lower side of neck e'tending fr• Sp8 9pper border of thyroid cartilage)
• :nf8 ;st above the sprasternal notch and t clavicle
• at8 (etween ant border of #t SCM and post border of t
• Moves p on degltition) doesn
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Di>erential Diagnosis
• ?rom history and clinical e'amination the swellinappears to be arising from thyroid gland+ So) for patient) my di>erential diagnoses are limited to
swellings primarily+
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1hyroid Swellings can be of ty
• GOITRE
• INFLAMMATORY GOITRE INFLAMMATORY NEOPLA
S:MP 12@:C :!?C1: (!:B!
C22:D D:??9SB#AS
A912:MM9! MA:B!A!
M91:!2D9A# M91:!2D9A# B#A!92MA129S
12@:CAD!2MA
#:D
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Colloid Boitre
IN FAVOUR OF AGAINST
=ell de7ned smooth solitary swellingwith absence of nodlarity
Se'
Absence of to'ic featres Short dration
Mobile Consistency
!on tender
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(enign 1hyroid Swelling
IN FAVOUR OF AGAINS
!o history of diclty in swallowing&breathing&*2 Se'
Age
Smooth single globlar swelling with well de7ned margins Short D
Mobile freely in all directions
!o ymphadenopathy
Consistency
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Malignant thyroid swelling
IN FAVOUR OF AGAINST
Se' Age
Consistency Smooth swelling with well dmargins
Short dration !o lymphadenopathy
?ree mobility
Absence of in7ltrative symptom
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2ther possibilities
•
2ther thyroid swellings that move p degltition can be
• 1hyroglossal cyst•
Sbhyoid brsitis• ymph node attached to crico8trache
framework
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1hyroglossal cyst
IN FAVOUR OF AGAINST
Moves with degltition Age
?irm consistency
ocated in lower !eckDoes not move on protsion
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Sbhyoid brsitis
IN FAVOUR OF AGAINST
Moves with degltition ocation
SiFe
Absence of tenderness
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ymph node attached to crico8tracframeworkIN FAVOUR OF AGAINST
Moves withdegltition
consistency
mobility
=ell de7ned margins
!o sggestive history of addictions or no e&o primary or node mass
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