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Medical Surgical thyroid disease trauma Uncategorized

Thyroids in all shapes and sizes

Some 25 years ago I wrote an article for presentation at the Ethiopian Medical Association meeting in Addis Ababa. I presented 300 cases of which the average weight was 500Gm. The incidence reported by the pathologist of cancer was 15%. The majority of malignant areas were very small and nothing further was done for those cases. In the following 25 years I saw many more.

male large goitre
This man’s specimen weighed in at 2kg. The depigmented area was due to previously applied local herbs, which didn’t cure the condition but had caused a lot of fibrosis down to the thyroid gland itself, increasing the difficulty in what is usually an easy plane of dissection.

collage of thyroids
In this collection of three goitres we have one from the country of Benin when I did a period there. Next an xray of a man who had a large intrathoracic extension.  You can see how far the trachea is pushed over. The photo of his specimen is below. On the right is a large mainly right sided mass, but with a moderate enlargement on the left.
large retrosternal goitre 4 copy
Below the finger is what was intrathoracic.
thyroid collage copy
Some had complications. The lady on the left had heart disease and was in CCF. The lady in the middle had waited until her anaplastic cancer had reached this stage. The man on the right has a follicular cancer and you can see by his left eyelids that he has Horner’s syndrome.
recurrent case thyroid
Recurrent disease. I don’t know who had done the initial surgery.
thyroid 9a copy
cancer means crab
thyroid exophth copy
hyperthyroidism with exophthalmos
collage 3
These 3 are all cases in which I was not initially involved. On the left is a girl who had her oesophagus injured all parathyroids removed and one recurrent nerve divided.  I have written about her in heatedstew under “a sad but interesting case”. heatedstew In the centre is a divided oesophagus occurring during thyroidectomy. You can see a n-g tube passing between the cut ends of the oesophagus. She developed hypoparathyroidism with severe psychiatric symptoms, and a hypothyroid situation. On the right is a case where the surgeon opted out in the middle of the procedure.

All the above cases and several hundred more were seen in the midst of a busy general surgical life.

Barry Hicks

 

 

 

 

 

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