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A 42-year-old woman presented with palpitations, anxiety, tremor, and weight loss. She had received a diagnosis of Graves' disease 15 years previously but had discontinued therapy more than 5 years previously. Over the ensuing years she noticed a slowly enlarging anterior neck mass, and in the months before presentation, dyspnea and dysphagia developed. There was no hoarseness, stridor, menstrual irregularity, heart failure, or psychosis, but a widened pulse pressure, pretibial myxedema, and proximal muscle weakness were noted. She had a large, nodular, and firm goiter (Panel A), which was also visible on computed tomography of the neck (Panel B). There . . . [Full Text of this Article] |
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