Thyroid swelling (history )

By Dr / Ahmed Osama Hassan

Assistant lecturer of pediatric surgery

Name Age Sex Occupation Residence Marital state Special habits

Personal history

20 years >>> papillary carcinoma physiological goitre

30 years >>> MNG , 1RY thyrotoxicosis

40 years >>> 2ry thyrotoxicosis , follicular carcinoma

50 years >>> anaplastic carcinoma

Age

female patient named …….& married since ….. And has …. Children , the youngest is ….. Years old . The patient is work

Example

Swelling in the neck + pain Toxic syptoms Pressure or neoplastic

Complaint

Swelling

In the front of the neck + lateral swelling !!!!

Present history

Slowly progressive 1. toxic and nodular goitre 2. papillary carcinoma

Rapid progressive Anaplastic carcinoma ( rapid onset )

Regressive : subacute thyroiditis

Course of swelling

In the gland Hge Inflammation Malignancy

Pain

Outside gland Bone ache Pain referred to ear

Pain … cont.

CVS Palpitation Exertional dyspnea

Toxic manifestations :

CNS

Insomnia Irritability Nervousness Nightmares

GIT Loss of weight Intolerance to hot tempreture

Rapid increase in size Hoarseness of voice Pain in the gland Pain referred to ear

Neoplastic symptoms

The condition started …. By swelling at lower part of the neck with gradual onset and slowly progressive course . The swelling moves up and down with deglutition . Swelling not painful

There is no symptoms suggest thyrotoxicosis

There is no symptoms suggest malignancy There is no pressure symptoms

Example of present history

Similar condition Other disease ( DM , HPN ) Operation Medication Drugs or irradiation

Past history

Medullar carcinoma Pendred syndrome Exposure to same condition Enzymatic deficiency

Family history

Thanks