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A 72-year-old woman presented for evaluation of dyspnea. Thirty-five years earlier, she had noticed a painless, slowly enlarging anterior neck mass. Since she was otherwise asymptomatic and many in her community had the same "problem," she did not seek medical attention. For the past few years, however, she has had a sensation of suffocating a few minutes after falling asleep. Physical examination showed a goiter that was large, lobular, soft, and painless, with cyanosis and protrusion of the inferior lip (Panel A), which was probably related to chronic respiratory insufficiency. Serum thyrotropin and free thyroxine levels were normal. Computed tomography . . . [Full Text of this Article] |
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