A 60-year-old woman, who had a thyroid gland weighing nearly 3 kg for at least 20 years, had it removed in a surgery at AIIMS last month. Her thyroid was nearly four times the normal weight of the gland, which is 10-25 gm.
Doctors at AIIMS said this was the largest case of an enlarged thyroid gland operated in the country.
In May, Noorjahan had come to AIIMS from Moradabad in Uttar Pradesh with a football-sized lump in the neck region. “Earlier, she had no problem in eating and breathing. She experienced no pain so she never consulted a doctor. Her thyroid stimulating hormone levels were below normal, and the enlarged gland was very close to her wind and food pipes. Her trachea (wind pipe) had become paper thin due to this constant pressure…,” Dr Sunil Chumber, a professor in the surgery department at AIIMS, explained.
Enlarged thyroid glands are medically termed goitres. Doctors at AIIMS said they operate at least 150-175 such cases annually. Doctors said in Noorjahan’s case, the tumour was found to be non-malignant and weighed 2.91 kg — outweighing the “monster” goitres operated at AIIMS that had weighed around 1 kg.
Noorjahan was admitted on May 20 and was operated upon on June 8. Since the enlarged thyroid was putting pressure on her trachea, doctors said they had to intubate her while she was still awake. She could be given anaesthesia only after this.
“As her neck was so distorted, and the enlarged structure was close to the two pipes and putting pressure on several critical nerves and blood vessels, it was a challenging procedure,” Dr Chumber said.
The thyroid removal surgery, which usually takes around an hour, took around six hours in this case.
Doctors said she was discharged 12 days after the surgery. Since the entire gland had to be removed, she will have to take thyroxin supplements for the rest of her life. Noorjahan showed hoarseness of voice after the surgery, but doctors said her voice had improved considerably in her last follow-up.
Doctors said thyroid gland enlargement or goitres usually occur due to iodine deficiency, and is common in the sub-Himalayan region, though this has been controlled to a large extent by government efforts at iodine supplementation.
“In this case, the patient had had eight pregnancies. A foetus takes a large chunk of the iodine from the mother’s body, so her multiple pregnancies could have contributed to her condition to some extent,” Dr Chumber said.