Total thyroidectomy in HIV positive patient with buffalo hump and taurine neck
| Autor: | Alessandro Stefani, Uliano Morandi, Beatrice Aramini, Elena Carrese |
|---|---|
| Přispěvatelé: | CARRESE, ELENA, Morandi Uliano, Stefani Alessandro, Aramini Beatrice. |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
endocrine system HIV positive Goiter endocrine system diseases Lipodystrophy medicine.medical_treatment BMI body mass index PIs protease inhibitors Highly active anti-retroviral therapy (HAART) Thyroidectomy HDL high-density lipoprotein ASA American society of anesthesiologists Article IDV indinavir 03 medical and health sciences 0302 clinical medicine Cytology LDL low-density lipoprotein Ddi didanosine EFV efavirenz Medicine HCV hepatitis c virus Total thyroidectomy business.industry Ultrasound AZT zidovudine Perioperative medicine.disease Trunk HAART highly active anti-retroviral therapy HIV human immunodeficiency virus 3TC lamivudine NRTIs nucleoside reverse transcriptase inhibitors 030220 oncology & carcinogenesis non-NRTIs non-nucleoside reverse transcriptase inhibitors 030211 gastroenterology & hepatology Surgery Radiology d4T stavudine business |
| Zdroj: | International Journal of Surgery Case Reports |
| Popis: | Highlights • A multinodular goiter in an HIV-positive with lipodystrophy, buffalo hump and taurine neck. • Needle aspiration biopsy was difficult to use to determine the presence of lipodystrophy. • The goiter was with retrosternal engagement and the ovalization of the tracheal lumen. • Surgical treatment was necessary due to the presence of dyspnea during exercise. • Importance of the perioperative teamwork, in particular to the patient positioning. Background The authors present a case of multinodular goiter in an HIV-positive patient affected by lipodystrophy with particular accumulation of adipose tissue in the region of the neck and trunk. Case presentation The patient, a 53-year-old man, presented with multinodular struma with partial retrosternal engagement, as well as multiple thyroid nodules increasing in size; some of the nodules had suspicious characteristics on ultrasound. Needle aspiration biopsy was difficult to use to determine the presence of lipodystrophy; however, even in the absence of cytology, surgical treatment was necessary due to the presence of dyspnea during exercise, the dimension of the goiter with retrosternal engagement, and the ovalization of the tracheal lumen. The patient underwent total thyroidectomy by anterior cervicotomy with particular attention to patient positioning because of the buffalo hump and taurine neck. Histological examination was positive for adenomatous hyperplasia with outbreaks of papillary microcarcinoma. Conclusions The aim of this case report was to highlight the importance of the perioperative teamwork, with particular attention to patient positioning before surgery, as well as professional collaboration and experience among the operators. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|