Long standing goitre of 40 years now presenting with difficulty breathing.
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The thyroid is markedly enlarged particularly at right lobe and contains multiple varying size nodular lesions with maximum diameter of 40 mm. Enlarged thyroid extends from C2 until T3 levels with mild retrosternal extension.
Trachea and other midline cervical structures shifted to the left side and tracheal narrowing is observed. There is no sign of local invasion of adjacent structures.
The parotid and submandibular glands have normal shape and size, without any space occupying lesions or calcification. No sign of lymphadenopathy is seen.
A typical case of a large multinodular goiter. It is important to look for retrosternal extension and extent of airway compression.