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Related Experiment Videos

[A case of mediastinal goiter with hyperthyroidisms]

T Tsushima1, M Minakawa, S Takahashi

  • 1First Department of Surgery, Hirosaki University School of Medicine, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|May 1, 1997
PubMed
Summary

A mediastinal tumor caused hyperthyroidism in a 65-year-old woman. Treatment with methimazole normalized thyroid function, and surgical removal of the follicular-fetal adenoma was successful, with no complications.

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Area of Science:

  • Endocrinology
  • Oncology
  • Thoracic Surgery

Background:

  • A 65-year-old woman presented with symptoms suggestive of hyperthyroidism and a mediastinal mass.
  • Initial evaluation included imaging that revealed a large mediastinal tumor compressing vital structures.

Observation:

  • The patient exhibited tachycardia, fever, sweating, and weight loss.
  • Thyroid function tests confirmed hyperthyroidism with suppressed TSH and elevated free T3 and free T4 levels.
  • Chest CT identified a 9x5x4 cm mediastinal tumor with cystic regions and calcifications.

Findings:

  • Methimazole treatment (300 mg/day) for 4 weeks resolved hyperthyroid symptoms and normalized thyroid function.
  • Surgical extirpation of the mediastinal tumor, a follicular-fetal adenoma with degenerative changes, was performed.

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  • Pathological examination excluded Graves' disease.

    • Implications:

    • This case highlights a rare instance of a mediastinal follicular-fetal adenoma causing secondary hyperthyroidism.
    • Successful management involved a combination of medical therapy and surgical resection.
    • The patient recovered well post-operatively, indicating favorable outcomes for this rare presentation.