Presentation
Neck swelling, presurgical assessment
Patient Data
Diffuse enlargement of thyroid, right lobe more than left. Right lobe measures 3.7 x 4.9 x 6.6 cm (TR x AP x CC), 56 g. Left lobe measures 2.1 x 3.3 x 5.1 cm (TR x AP x CC), 17 g. Right lobe is replaced by a large well defined hypodense nodule measuring 5.1 x 3.6 cm. Retroclavicular extension. No retrosternal extension. Mild left deviation of trachea. No luminal narrowing.
Case Discussion
A non-contrast multiplanar CT usually suffices to ascertain the caudal extent of a goiter. When they do descend to the level of the great vessels, a contrast-enhanced CT scan ensures better delineation of fat planes with vessels.
NB: caution is always required with administering iodinated contrast media to patients with thyroid disease, in case they have been scheduled for radioiodine therapy in the next ~3 months.
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