Published online Mar 16, 2024. doi: 10.12998/wjcc.v12.i8.1497
Peer-review started: December 12, 2023
First decision: December 21, 2023
Revised: January 7, 2024
Accepted: February 18, 2024
Article in press: February 18, 202
Published online: March 16, 2024
Processing time: 90 Days and 13.6 Hours
Patients rarely develop complicated infections in thyroid cysts. Here, we describe a patient with chronic infected unilateral giant thyroid cyst related to diabetes mellitus (DM).
A 66-year-old male was admitted due to an evident neck lump for 5 d after approximately 40 years of gradually progressive neck mass and 7 years of DM. Doppler ultrasound and computed tomography scan showed a giant lump in the left thyroid gland lobe. He was diagnosed with a large thyroid nodule complicated by tracheal dislocation and had surgical indications. Surgical exploration revealed evident inflammatory edema and exudation between the left anterior neck muscles, the nodule and glandular tissue. Fortunately, inflammatory lesions did not affect major neck vessels. Finally, a left partial thyroidectomy was performed. Macroscopic observation showed that the cystic thyroid mass consisted of extensive cystic wall calcification and was rich in massive rough sand-like calculi content and purulent matter. Postoperative pathology confirmed benign thyroid cyst with chronic infection.
The progression of this chronic infectious unilateral giant thyroid cyst may have been related to DM, and identifying blood vessels involvement can prevent serious complications during operation.
Core Tip: When encountering a huge thyroid mass with coinfection in the clinical setting, comprehensive examination is required to confirm the cause of its formation and subsequent individualized treatment strategies. With carefully applied surgical procedures, complications such as severe intraoperative and postoperative hemorrhage can be avoided or reduced. This report may provide clinicians with perspectives for the diagnosis and treatment of giant thyroid cysts complicated by infection under diabetes mellitus conditions.