Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To review our experience with the surgical treatment of cervicomediastinal goiters. Charts of patients with cervicomediastinal goiters undergoing thyroidectomy within the last 10 years were reviewed. Data regarding previous disease, clinical features, diagnostic procedures, surgical intervention and postoperative evolution were recorded. Twenty-eight patients (19 female and 9 male) 62 +/- 2 years old underwent surgery to treat cervicomediastinal goiter during the period reviewed. Among patients with compressive manifestations (75.6%), dyspnea was the most common (36.6%) symptom, followed by dysphagia and superior vena cava syndrome. An extrathoracic obstruction pattern was found in 3 (11.2%) cases. Thyroid scintigraphy showed increased thyroid size in 25 patients, and in 9 of them a cold nodule was present as well. Fine needle aspiration of the thyroid gland was performed in 5 patients; malignancy was found only in 1 case. Fiberoptic bronchoscopy was performed in 15 patients; in 7 (25%) tracheal compression was found. In these patients there was no higher rate of postoperative complications. Cervicotomy was the surgical approach used in 23 (82.1%) patients. Cervicosternotomy was used in 4 (14%), and thoracotomy in 1 (3.6%). The surgical procedure was bilateral subtotal thyroidectomy in 15 (53.6%), total thyroidectomy in 3 (10.7%), right lobectomy in 6 (21.4%), and left lobectomy in 4 (14.3%). Colloid goiter was the most common histological type (42.8%), followed by nodular hyperplasia (35.8%), cancer (10.7%) and adenoma (10.7%). Three patients showed transient recurrent paralysis in the postoperative period, and another 3 patients presented major complications: 1 case of postoperative bleeding and 2 cases of tracheomalacia requiring tracheostomy. Cervicomediastinal goiter is a disease that may involve compressive symptoms. In our experience, most cases were resected through cervicotomy, colloid goiter and the nodular hyperplasia being the most common histological types. There was no relationship between surgical procedure and the incidence of complications.
 ...
PMID:[Surgical treatment of cervicomediastinal goiter]. 909 Nov 19

We report a 41 years old man admitted with a tender goiter, fever, thyrotoxic manifestations and atrial fibrillation. Laboratory confirmed the diagnosis of subacute thyroiditis and treatment with aspirin and propranolol was started, obtaining a rapid relief of symptoms and normalization of heart rate. On the tenth day after admission, severe dysphagia, dysphonia, irritative cough and further enlargement of the neck mass developed. Fine needle aspiration of the mass and thyroid ultrasound lead to the diagnosis of a thyroidal abscess, which was surgically excised, draining 250 ml of purulent material. Cultures were positive for Staphylococcus aureus. Patient was treated during 21 with cloxacilyn and discharged with normal thyroid function. Long term follow up has been uneventful.
 ...
PMID:[Subacute thyroiditis and concurrent suppurative thyroiditis in one case]. 911 Apr 88

We report a 26 years old male with secondary amyloidosis and chronic renal failure who consulted due to a rapidly growing goiter associated with coarseness and dysphagia. Serum levels of thyroid hormones and TSH were normal and a neck CT scan showed a big mass in the anterior and lateral regions, that compressed neighboring structures. The patient was subjected to a total thyroidectomy and the pathological study revealed a diffuse fatty and amyloid infiltration of the thyroid gland. There was no evidence of malignancy.
 ...
PMID:[Diffuse fatty infiltration of the thyroid gland associated to amyloidosis in a patient with chronic renal failure]. 923 16

A 60-year-old man noticed rapid enlargement of a long-standing thyroid goitre, with dysphagia and difficulty in breathing. Thyrotoxicosis was diagnosed. Chest X-ray revealed multiple pulmonary metastases. He underwent near-total thyroidectomy. The histopathology revealed an undifferentiated thyroid carcinoma with some areas of papillary carcinoma and its follicular variant. Postoperative 131I total body scan showed residual thyroid tissue in the neck and one functioning metastasis in the right rib, posteriorly. The patient's condition deteriorated rapidly and he died from pneumonia. The autopsy showed widespread metastases of undifferentiated thyroid carcinoma. Only the right rib contained the follicular variant of papillary carcinoma.
 ...
PMID:Primary thyroid carcinoma and thyrotoxicosis. 953 90

The authors present a case of 60-year-old woman who suffered from a mycosis (Candidosis) infection of the ectopic lingual thyroid gland. Intensive inflammatory process caused enlargement of lingual goiter and dysphagia occurred consequently. Right diagnosis was made after scyntygraphic examination (the presence of lingual thyroid gland only), as well as histopathological and microbiological examinations which revealed the presence of Candida forms. Recovery was achieved after 5 weeks of antifungal treatment--Diflucan during a 2-week initial period, then followed by 3 weeks of local treatment with nystatin.
 ...
PMID:[Mycosis infection (candidiasis) of the lingual thyroid gland]. 959 32

Retrosternal goiter is defined as any goiter in which at least 50 per cent of the thyroid resides below the level of the thoracic inlet. The incidence of retrosternal goiter varies from 3 to 20 per cent with respect to thyroidectomy patients. A retrospective chart review from June 1991 to December 1997 found 232 thyroidectomies performed at our institution. Sixteen patients were found to have retrosternal goiters (6.9%). The mean age was 57.8 years (range, 34-92). All were of benign pathology. Symptoms included shortness of breath (68.8%), hoarseness (37.5%), dysphagia (31.3%), and superior vena cava obstruction (6.25%). Thirteen patients were female (81.3%). Fifteen patients had surgical intervention (93.8%). Total thyroidectomy was performed in nine cases (60%), whereas lobectomy was performed in six cases (40%). All treated patients had complete resolution of symptoms. A cervical incision alone was used in 13 cases (86.7%). Complications consisted of one postoperative pleural effusion and in one case a traumatic C5 nerve root compression occurred. There were no instances of long-term vocal cord paralysis or hypoparathyroidism. There was no perioperative mortality. In the majority of patients with retrosternal goiter, surgery can be done expeditiously through a cervical incision with minimal morbidity and mortality.
 ...
PMID:Retrosternal goiter: a six-year institutional review. 973 21

Enlargement of the thyroid is common, especially in areas of endemic iodine deficiency. Substernal enlargement of a goitre can cause compression of several mediastinal structures. As a consequence of tracheal compression and tracheomalacia, syndromes of chronic respiratory distress occur and intercurrent upper respiratory infections may lead to acute respiratory failure. Superior vena cava syndrome secondary to compression by a substernal goitre may be complicated by venous thrombosis. Although dysphagia is the most frequent oesophageal symptom of a substernal goitre, upper gastrointestinal bleeding from 'downhill' oesophageal varices may be an initial presentation. Arterial compression or thyrocervical steal syndrome by large substernal goitres occasionally cause cerebral hypoperfusion and stroke. Recurrent and phrenic nerve palsies, as well as Horner's syndrome, occur secondary to non-malignant mediastinal goitres and may resolve after surgery. Substernal goitres rarely cause therapy-resistant pleural effusions, chylothorax and pericardial effusion. In conclusion, although cervical goitres are easily recognised, the initial presentation of mainly substernal goitres may be unusual.
 ...
PMID:Compression syndromes caused by substernal goitres. 1019 9

Between 1984 and 1997 year 4985 patients underwent surgical treatment due to various thyroid gland diseases, among them were 28 (0.6%) patients with intrathoracic goitre, but only in one case (0.002%) the signs of superior vena cava syndrome (SVCS) were observed: oedema and lividity of the face, enlargement of jugular veins and superior limbs' veins. In addition the patient manifested subsequently growing dyspnoea, dysphagia and hoarseness. In diagnose essential were X-ray examination of the chest (widening of mediastinal shadow), X-ray examination of the trachea (dislocation and compression of the trachea), X-ray of esophagus with contrast (compression from the outside), ultrasonography of thyroid gland. Intraoperatively, after it was confirmed that the SVCS was caused by compression of the intrathoracic right lobe of thyroid gland, the oblong sternotomy was performed to provide the proper surgical access for subtotal thyroidectomy. The weight of resected tissues of thyroid gland was 1036 g. In histopathological examination the diagnosis of multinodular toxic goitre was confirmed.
 ...
PMID:[Intrathoracic goiter as a cause of superior vena cava syndrome]. 1021 81

This report describes the surgical experience gained from 32 patients with substernal goitre, operated on during January 1995 to December 1997. The material corresponds to 15.7% of the total thyroidectomies performed. The diagnosis was clinical. In spite of 65.6% of the patients being asymptomatic, breathing problems, dysphagia and hyperthyroidism were observed. The patients underwent tests of thyroid function, simple chest radiograph and computerized tomography of mediastinum. All patients underwent surgical treatment through a transverse cervical incision. Two patients (6.25%) needed median sternotomy. Vocal cord palsy (3.12%), transient hypocalcemia (6.25%) and one death due to cardiac causes (3.12%) were the complications that occurred.
 ...
PMID:Surgical treatment of the substernal goitre. 1053 74

Large benign goiter with a cervical and intrathoracic retrotracheal location is uncommon, but troublesome, since it affects the upper mediastinum and usually causes dyspnea, dysphagia or vascular obstruction; on the other hand, a large mediastinal cyst of thyroid origin complicated by a massive, spontaneous hemorrhage is an exceptional event, implicating vital prognosis through an acute tracheal compression. A 45-year-old-man presented all these complications of a previously neglected nodular-cystic goiter, causing an acute respiratory distress. An emergency diagnosis and consequent surgery, in delayed urgency, were performed. This case is presented because of its rarity. Its clinic management is discussed, in the framework of the existing literature.
 ...
PMID:[An acute superior mediastinal syndrome with critical tracheal stenosis due to benign multinodular goiter complicated by intracystic hemorrhage]. 1057 22


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>