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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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