PSAT333 Case Of a Large Adenomatoid Hyperplastic Thyroid Goiter

Abstract An 81-year-old woman presented to the emergency department for evaluation of shortness breath, dysphagia and chest tightness. In department, imaging was obtained, with CXR showing complete opacification R hemithorax. Follow up CT Chest showed large mediastinal mass contingent right lobe thyroid, along volume (transudative) pleural effusion. Patient underwent thoracentesis improvement in her but tightness persisted. IR biopsy which confirmed indeed thyroid origin. At this time, Endocrinology consulted concerns thyrotoxicosis, goiter, as lab work returned suppressed TSH (<0.01 mcIU/mL), normal Free T4 (1.14 ng/dL). On examination, team found patient be clinically euthyroid, vital signs only ongoing complaints deep inspiration. Decision made go forward resection mass, a multidisciplinary approach involving ENT Cardiothoracic Surgery. The began procedure by dissecting from remaining tissue. gland noted track inferiorly posteriorly into chest, decision truncate portion superior clavicle. time it felt that further manipulation high risk position. then handed off cardiothoracic surgery who, using robotic assistance, took transdiaphragmatic approach. After roughly 3 hours dissection, goiter placed an endo-catch bag able removed through transabdominal/diaphragmatic incision. remainder left safely place. end 13.7 cm length weighed 532 g. Average weight iodine replete populations remains 20 Pathology adenomatoid hyperplasia all 4 specimens. Postoperatively did well follow scheduled. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00