Surgical Management of a Giant Papillary Thyroid Carcinoma: A Case Report

Abstract

Introduction: Giant goitres are uncommon thyroid enlargements that may extend over decades, often resulting in compressive symptoms and aesthetic concerns. Although most long-standing goitres are benign, the potential for malignant transformation exists. Early diagnosis and timely surgical management are crucial to prevent complications and ensure optimal outcomes.

Case Presentation: We report a case of a 63-year-old female who presented with a massive anterior neck swelling that had been progressively enlarging over a period of 20 years. Clinical evaluation and ultrasonography were performed, followed by fine needle aspiration cytology (FNAC), which suggested a follicular neoplasm. The patient was planned for surgical excision under general anesthesia.

Results: Intraoperatively, a well-encapsulated, highly vascular thyroid mass was identified and successfully excised. The specimen weighed approximately 4 kg (8.81 lbs). Histopathological examination confirmed the diagnosis of papillary thyroid carcinoma with areas of cystic degeneration. The postoperative course was uneventful, and the patient recovered without complications.

Conclusion: This case highlights the rarity of giant goitres and underscores the importance of early diagnosis, careful preoperative assessment, and meticulous surgical planning. Even in long-standing goitres presumed benign, the risk of underlying malignancy should be considered. Timely surgical intervention not only minimizes morbidity but also facilitates early detection and treatment of occult malignancies, thereby improving patient outcomes.