Progressive increase in midline swelling and dyspnea
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Calls attention a severe growth of the thyroid gland primarily of the right lobe, which extend to middle and upper mediastinum , with craniocaudal extension of 9.8 cm. In higher mediastinum, thyroid mass produce severe tracheal compression in the transverse axis allowing air column, 4 mm thick.There are a mediastinal adenopathy retrotracheal 3.6 cm, also with marked heterogeneity in the enhancement of contrast.
Great thyroid goiter with large heterogeneous nodules extending to middle mediastinum, associated with mediastinal lymphadenopathy,
A histological study to assess malignancy is suggested.