MASSIVE MULTINODULAR GOITER (MNG) CAUSING TRACHEAL AND BILATERAL GREAT CERVICAL VESSELS COMPRESSION TREATED WITH TOTAL THYROIDECTOMY: A CASE REPORT FROM RURAL HOSPITAL

Introduction: Multinodular goiter (MNG) is a common thyroid condition that is usually asymptomatic. However, in rare instances where the gland enlarges substantially, it can cause significant compression of the airway and important cervical vessels.

Case Presentation: A 49-year-old woman with a 10-year history of a progressively enlarging neck mass presented with symptoms of airway obstruction and bilateral great vessel compression, including dyspnea, facial swelling, and orthostatic dizziness. Imaging revealed a massively enlarged multinodular thyroid gland causing tracheal deviation and bilateral compression of the carotid arteries and jugular veins, without extension into the thoracic inlet. Thyroid function tests confirmed a euthyroid state.The patient underwent a successful total thyroidectomy. Histopathological examination showed a cystic adenomatous goiter. Postoperative recovery was uneventful except for transient hoarseness, which resolved during follow-up.

Discussion: A goiter is defined as an enlargement of the thyroid gland, typically characterized by swelling in the anterior neck. It can be classified as endemic or non-endemic, diffuse or nodular, and toxic or non-toxic. This rare presentation underscores the potential severity of untreated MNG.