ketendoКлиническая и экспериментальная тиреоидологияClinical and experimental thyroidology1995-54722310-3787Endocrinology Research Centre10.14341/ket12752ketendo-12752Research ArticleКлинический случайCase ReportКомпрессионный синдром при гигантском эутиреоидном зобеCompression syndrome in giant euthyroid goiterhttps://orcid.org/0000-0001-6385-540XДемидоваТ. Ю.DemidovaT. Yu.

Демидова Татьяна Юльевна, доктор медицинских наук, профессор 

Москва

eLibrary SPIN: 9600-9796

Tatiana Y. Demidova, MD, Professor

Moscow

eLibrary SPIN: 9600-9796

t.y.demidova@gmail.comhttps://orcid.org/0000-0002-6826-5924КочинаА. С.KochinaA. S.

Кочина Анна Сергеевна, ассистент кафедры эндокринологии лечебного факультета

117997, Москва, ул. Островитянова, д. 1

Anna S. Kochina, MD, assistant

1 Ostrovityanova street, 117997 Moscow

anna_kochina_@mail.ruhttps://orcid.org/0000-0002-2552-5028ИброхимовХ. Х.IbrokhimovKh. Kh.

Иброхимов Худойберди Хусанжон угли, клинический ординатор 

Москва

Khudoyberdi Kh. Ibrokhimov, resident

Moscow

khudoyberdi.ibrokhimov@mail.ruХалилаеваА. П.KhalilaevaA. P.

Халилаева Айгул Парахат кызы, клинический ординатор 

Москва

Aygul P. Khalilaeva, resident

Moscow

aygulxalilaeva@gmail.comФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава РоссииRussian National Medical University. Ministry of Health of Russia2022130720231841419Copyright © Демидова Т.Ю., Кочина А.С., Иброхимов Х.Х., Халилаева А.П., 20232023Демидова Т.Ю., Кочина А.С., Иброхимов Х.Х., Халилаева А.П.Demidova T.Y., Kochina A.S., Ibrokhimov K.K., Khalilaeva A.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cet-endojournals.ru/jour/article/view/12752

С учетом широкого распространения йодного дефицита, диффузный и диффузно-узловой эутиреоидный зоб является актуальной проблемой. Зоб крупных размеров нуждается в освещении с позиции как возможных осложнений для пациента, включающих снижение качества жизни и компрессионный синдром, так и сложности хирургического лечения, принимая во внимание техническую сложность операции и высокую вероятность развития интраоперационных и отдаленных осложнений. В статье описан клинический случай пациента, поступившего в отделение эндокринологии с диагнозом «диффузно-узловой зоб 2 степени» для обследования с жалобами на огромное деформирующее контуры шеи образование, затрудненное дыхание при ходьбе и во время сна. Из анамнеза известно, что пациент наблюдается около 10 лет у эндокринолога по поводу узлового зоба. Пациенту было неоднократно предложено оперативное лечение, от которого он категорически отказывался. В отделении эндокринологии пациенту было проведено комплексное обследование по оценке состояния и функции щитовидной железы, а также выявлению возможных осложнений.

Given the widespread iodine deficiency, diffuse and diffuse nodular euthyroid goiter is an urgent problem. A large goiter needs to be highlighted both from the perspective of possible complications for the patient, including a decrease in the quality of life and compression syndrome, as well as from the perspective of the complexity of surgical treatment, given the technical complexity of the operation and the high probability of intraoperative and postoperative complications. The article describes a clinical case of a patient admitted to the endocrinology department with a diagnosis of diffuse nodular goiter of the 2nd degree for examination with complaints of a huge deforming formation of the neck contours, difficulty breathing when walking and during sleep. It is known from the anamnesis that the patient has been observed for about 10 years by an endocrinologist with nodular goiter. The patient was repeatedly offered surgical treatment, which he categorically refused. In the Department of endocrinology, the patient underwent a comprehensive examination to assess the condition and function of the thyroid gland, as well as to identify possible complications.

диффузно-узловой зобэутиреоздефицит йодатиреоидэктомиягигантский зобdiffuse nodular goitereuthyroidismiodine deficiencythyroidectomygiant goiterReferencesКуринова А.Н., Никитина Т.В., Трухина Д.А., и др. Становление эндокринологии Древнего мира // Проблемы Эндокринологии. — 2022. — Т. 68. — №1. — С. 4-7. doi: https://doi.org/10.14341/probl12878Kurinova AN, Nikitina T V., Trukhina DA, et al. The formation of endocrinology in the ancient times. Problems of Endocrinology. 2022;68(1):4-7. (In Russ.). doi: https://doi.org/10.14341/probl12878Alkabban FM, Patel BC. Nontoxic Goiter. 2022 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.Alkabban FM, Patel BC. Nontoxic Goiter. 2022 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.Hetzel B. Iodine deficiency disorders (IDD) and their eradication. Lancet. 1983;322(8359):1126-1129. doi: https://doi.org/10.1016/S0140-6736(83)90636-0Hetzel B. Iodine deficiency disorders (IDD) and their eradication. Lancet. 1983;322(8359):1126-1129. doi: https://doi.org/10.1016/S0140-6736(83)90636-0Zimmermann MB, Jooste PL, Pandav CS. Iodinedeficiency disorders. Lancet. 2008;372(9645):1251-1262. doi: https://doi.org/10.1016/S0140-6736(08)61005-3Zimmermann MB, Jooste PL, Pandav CS. Iodinedeficiency disorders. Lancet. 2008;372(9645):1251-1262. doi: https://doi.org/10.1016/S0140-6736(08)61005-3Hintze G, Koebberling J. Treatment of iodine deficiency goiter with iodine, levothyroxine or a combination of both. Thyroidology. 1992;(4):37-40.Hintze G, Koebberling J. Treatment of iodine deficiency goiter with iodine, levothyroxine or a combination of both. Thyroidology. 1992;(4):37-40.Gartner R, Dugrillon A, Bechtner G. Evidence that iodolactones are the mediators of growth inhibition by iodine on the thyroid. Acta Med Austriaca. 1996;23(1-2):47-51.Gartner R, Dugrillon A, Bechtner G. Evidence that iodolactones are the mediators of growth inhibition by iodine on the thyroid. Acta Med Austriaca. 1996;23(1-2):47-51.Российская ассоциация эндокринологов. Российская ассоциация врачей ультразвуковой диагностики. Заболевания и состояния, связанные с дефицитом йода. Клинические рекомендации. 2020 г. Доступно по: https://rae-org.ru/system/files/documents/pdf/zabolevaniya_i_sostoyaniya_svyazannye_s_deficitom_yoda.pdf Ссылка активна на 15.07.2023.Rossijskaja associacija jendokrinologov. Rossijskaja associacija vrachej ul’trazvukovoj diagnostiki. Zabolevanija i sostojanija, svjazannye s deficitom joda. Klinicheskie rekomendacii. 2020. (In Russ.). Доступно по: https://rae-org.ru/system/files/documents/pdf/zabolevaniya_i_sostoyaniya_svyazannye_s_deficitom_yoda.pdf Ссылка активна на 15.07.2023.Carlé A, Krejbjerg A, Laurberg P. Epidemiology of nodular goitre. Influence of iodine intake. Best Pract Res Clin Endocrinol Metab. 2014;28(4):465-479. doi: https://doi.org/10.1016/j.beem.2014.01.001Carlé A, Krejbjerg A, Laurberg P. Epidemiology of nodular goitre. Influence of iodine intake. Best Pract Res Clin Endocrinol Metab. 2014;28(4):465-479. doi: https://doi.org/10.1016/j.beem.2014.01.001Unlu MT, Kostek M, Aygun N, et al. Non-Toxic Multinodular Goiter: From Etiopathogenesis to Treatment. Sisli Etfal Hastan Tip Bul. 2022;56(1):21-40. doi: https://doi.org/10.14744/SEMB.2022.56514Unlu MT, Kostek M, Aygun N, et al. Non-Toxic Multinodular Goiter: From Etiopathogenesis to Treatment. Sisli Etfal Hastan Tip Bul. 2022;56(1):21-40. doi: https://doi.org/10.14744/SEMB.2022.56514Troshina EA, Platonova NM, Panfilova EA, Panfilov KO. The analytical review of monitoring of the basic epidemiological characteristics of iodine deficiency disorders among the population of the Russian Federation for the period 2009—2015. Problems of Endocrinology. 2018;64(1):21-37. doi: https://doi.org/10.14341/probl9308Troshina EA, Platonova NM, Panfilova EA, Panfilov KO. The analytical review of monitoring of the basic epidemiological characteristics of iodine deficiency disorders among the population of the Russian Federation for the period 2009—2015. Problems of Endocrinology. 2018;64(1):21-37. doi: https://doi.org/10.14341/probl9308Магомедов А.Г., Дибиров А.Д., Абдулхаликов А.С., и др. Гигантский зоб в практике эндокринного хирурга (описание серий наблюдений) // Вестник ДГМА. — 2014. — Т. 3. — №12. — С. 66-68.Magomedov AG, Dibirov AD, Abdulkhalikov AS, et al. Giant goiter in the practice of endocrine surgery (description series of observations). Vestnik DGMA. 2014;3(12):66-68. (In Russ.).Anders HJ. Compression syndromes caused by substernal goitres. Postgrad Med J. 1998;74(872):327-329. doi: https://doi.org/10.1136/pgmj.74.872.327Anders HJ. Compression syndromes caused by substernal goitres. Postgrad Med J. 1998;74(872):327-329. doi: https://doi.org/10.1136/pgmj.74.872.327Din WBM, Farrar E, Liu C, Moor J. Cough syncope and tracheal compression secondary to a retrosternal goitre: looking for a pulmonary embolism. BMJ Case Rep. 2019;12(4):e228997. doi: https://doi.org/10.1136/bcr-2018-228997Din WBM, Farrar E, Liu C, Moor J. Cough syncope and tracheal compression secondary to a retrosternal goitre: looking for a pulmonary embolism. BMJ Case Rep. 2019;12(4):e228997. doi: https://doi.org/10.1136/bcr-2018-228997Abdullah AS, Bahjat AS, Mohammed AA. Huge toxic goiter extending to the posterior mediastinum; Case report with literature review. Int J Surg Case Rep. 2019;62(1):69-72. doi: https://doi.org/10.1016/j.ijscr.2019.08.016Abdullah AS, Bahjat AS, Mohammed AA. Huge toxic goiter extending to the posterior mediastinum; Case report with literature review. Int J Surg Case Rep. 2019;62(1):69-72. doi: https://doi.org/10.1016/j.ijscr.2019.08.016Anders HJ. Compression syndromes caused by substernal goitres. Postgrad Med J. 1998;74(872):327-329. doi: https://doi.org/10.1136/pgmj.74.872.327Anders HJ. Compression syndromes caused by substernal goitres. Postgrad Med J. 1998;74(872):327-329. doi: https://doi.org/10.1136/pgmj.74.872.327Hamdan A-L, Jabbour J, Al Zaghal Z, Azar ST. Goiter and Laryngopharyngeal Reflux. ISRN Endocrinol. 2012;2012(1):1-6. doi: https://doi.org/10.5402/2012/208958Hamdan A-L, Jabbour J, Al Zaghal Z, Azar ST. Goiter and Laryngopharyngeal Reflux. ISRN Endocrinol. 2012;2012(1):1-6. doi: https://doi.org/10.5402/2012/208958Agger-Nielsen H, Døssing H, Sørensen JR. Syncope due to giant goitre. Ugeskr Laeger. 2018;180(24):V01180048Agger-Nielsen H, Døssing H, Sørensen JR. Syncope due to giant goitre. Ugeskr Laeger. 2018;180(24):V01180048Hauten P, Bleumink G, Hovens M, et al. Unexpected Complication of a Multinodular Goitre. Eur J Case Reports Intern Med. 2016;3(2):190-195. doi: https://doi.org/10.12890/2016_000363Hauten P, Bleumink G, Hovens M, et al. Unexpected Complication of a Multinodular Goitre. Eur J Case Reports Intern Med. 2016;3(2):190-195. doi: https://doi.org/10.12890/2016_000363McNeill CJ, Sinnott JD, Howlett D. Bilateral brachiocephalic vein compression: an unusual and rare presentation of multinodular goitre. BMJ Case Rep. 2016;3(2):bcr2016217074. doi: https://doi.org/10.1136/bcr-2016-217074McNeill CJ, Sinnott JD, Howlett D. Bilateral brachiocephalic vein compression: an unusual and rare presentation of multinodular goitre. BMJ Case Rep. 2016;3(2):bcr2016217074. doi: https://doi.org/10.1136/bcr-2016-217074Manning PB, Thompson NW. Bilateral phrenic nerve palsy associated with benign thyroid goiter. Acta Chir Scand. 1989;(155):429-430Manning PB, Thompson NW. Bilateral phrenic nerve palsy associated with benign thyroid goiter. Acta Chir Scand. 1989;(155):429-430Bellantone R, Lombardi CP, Bossola M, et al. Total thyroidectomy for management of benign thyroid disease: Review of 526 cases. World J Surg. 2002;26(12):1468-1471. doi: https://doi.org/10.1007/s00268-002-6426-1Bellantone R, Lombardi CP, Bossola M, et al. Total thyroidectomy for management of benign thyroid disease: Review of 526 cases. World J Surg. 2002;26(12):1468-1471. doi: https://doi.org/10.1007/s00268-002-6426-1Vetshev PS, Yankin PL, Zhivotov VA, et al. Risk factors and prognosis of voice disorders after surgical treatment of thyroid and parathyroid diseases. Pirogov Russian Journal of Surgery. 2019;(4):5-14. doi: https://doi.org/10.17116/hirurgia20190415Vetshev PS, Yankin PL, Zhivotov VA, et al. Risk factors and prognosis of voice disorders after surgical treatment of thyroid and parathyroid diseases. Pirogov Russian Journal of Surgery. 2019;(4):5-14. doi: https://doi.org/10.17116/hirurgia20190415Belokonev VI, Pushkin SYu, Kovaleva ZV, et al. Safe thyroidectomy for thyroid and parathyroid diseases. Pirogov Russian Journal of Surgery. 2022;(6):62-71. doi: https://doi.org/10.17116/hirurgia202206162Belokonev VI, Pushkin SYu, Kovaleva ZV, et al. Safe thyroidectomy for thyroid and parathyroid diseases. Pirogov Russian Journal of Surgery. 2022;(6):62-71. doi: https://doi.org/10.17116/hirurgia202206162Shulutko AM, Semikov VI, Gryaznov SE, et al. Risk of hypocalcemia after thyroid surgery. Pirogov Russian Journal of Surgery. 2015;(11):35-40. doi: https://doi.org/10.17116/hirurgia20151135-40Shulutko AM, Semikov VI, Gryaznov SE, et al. Risk of hypocalcemia after thyroid surgery. Pirogov Russian Journal of Surgery. 2015;(11):35-40. doi: https://doi.org/10.17116/hirurgia20151135-40

The authors declare that there are no conflicts of interest present.