Benign multinodular goitre presenting as acute decompensated type two respiratory failure.

Area of Science:

• Endocrinology
• Pulmonology
• Surgical Oncology

Background:

• Benign goitres can lead to acute airway obstruction, a rare but life-threatening complication.
• The initial presentation of goitre with decompensated respiratory failure is exceptionally uncommon and diagnostically challenging.

Observation:

• A woman in her 50s, previously diagnosed with asthma, presented with acute decompensated type two respiratory failure.
• A large goitre with retrosternal extension causing critical tracheal compression was identified, complicating the diagnosis.

Findings:

• The patient's history of asthma presented a diagnostic challenge, potentially masking the underlying airway obstruction.
• Initial management involved non-invasive ventilation, with diagnosis of upper airway obstruction being initially unclear.

Implications:

• Prompt surgical intervention, such as hemithyroidectomy, can effectively resolve respiratory compromise caused by tracheal compression from benign goitres.
• This case highlights the importance of considering uncommon causes of respiratory failure, even in patients with pre-existing respiratory conditions.