PUNE: A 45-year-old woman got operated in a city-based hospital to remove a tumour of one kilogram from her neck. The patient noticed a swelling in the neck 20 years back and at that time, doctors informed her that it was due to thyroid enlargement. She was advised to surgically removed the gland but being apprehensive of surgery, she did not pay heed to it. After 20 years of the first diagnosis, the tumour became the size of a watermelon. The 45-year-old patient recently underwent surgery to remove it.
The patient was referred from Endocrinologist Dr Shreerang Godbole to Dr Pradeep Sharma, a senior surgeon at Jehangir Hospital who specialises in General, GI and Endocrine surgery. She was prepared for the surgery as the surgery was quite delicate due to its very nature as well as the sheer size of the gland.
Dr Shreerang Godbole, an Endocrinologist at Jehangir Hospital, said that most women would be concerned for cosmetic reasons. But this patient was different.
“She did the tests regularly and was rigorous with follow-up so as to ensure that there was no medical issue due to the swelling. Finally, she agreed after a lot of persuasion from my end that no harm would come to her on surgery. The incentive was to get rid of it and carry on life normally. What I would like to say is one should go for surgery if it’s hampering one’s life or creating a pressure on the windpipe or causing cancer. Otherwise, one should not necessarily intervene surgically with the body,” said Godbole.
A problem seen with long-standing goitres is softening of the windpipe due to pressure, also called as Tracheomalacia, which can result in choking before or after surgery.
In this case, the patient has Type 3 Tracheomalacia, which made her surgery risky. Dr Pradeep Sharma further explained that sometimes, this can lead to making a hole in the windpipe, in the neck and putting a plastic tube for some days (also known as Tracheostomy).
“Thyroid surgery also carries a chance of change in voice as the nerves going to the voice box (Larynx) are in close proximity to the thyroid gland. There are four small glands called Parathyroid glands situated behind the Thyroid, which control the calcium levels in the body and hence need to be preserved. All this makes thyroid surgery a very delicate surgery, especially in a situation like this case, which involved a very large Goitre,” said Sharma.
ABOUT THE TUMOUR
- Thyroid Gland is a hormone-producing gland situated in front of the neck over the windpipe and produces thyroid hormones (T3 and T4), which are responsible for the metabolism of the body.
- When the hormone levels are more, they increase the metabolism of the body and cause weight loss along with many effects over all the systems of the body (Hyperthyroidism). When the hormone levels reduce, they slow the metabolism of the body and cause weight gain in addition to other deleterious effects on the body systems (Hypothyroidism).
- When the gland size increases, it causes a condition called ‘Goitre’. Iodine deficiency goitres are now rarely seen as most of us consume iodised salt in our diet. Other causes of goitre are familial and hereditary deficiency of enzymes responsible for hormone manufacturing, autoimmune conditions, infections, radiations and occasionally cancers.