Mr. Tri, 45 years old, has both a goiter and a large lipoma in his thyroid gland, pressing on important structures in his neck, causing difficulty breathing.
Lipoma is a common benign tumor, formed from fatty tissue, often appearing on the trunk, neck, back, thighs, and arms. On November 1, MSc. Le Thi Ngoc Hang, Department of Thoracic and Vascular Surgery, Tam Anh General Hospital, Ho Chi Minh City, said lipomas like Mr. Tri’s in the thyroid gland are very rare. “After more than 20 years in the profession, this is the first time I have met a patient with a lipoma in the thyroid lobe,” said Dr. Hang.
Mr. Tri has had a benign goiter in the right thyroid lobe for the past 10 years. The nodule is small and does not require treatment. Two years ago, his neck became enlarged and he occasionally had mild difficulty breathing. Examination at the local hospital found no abnormalities. Recently, he was tired, had difficulty breathing, and had a swollen neck, so he went to Tam Anh Hospital for examination.
Doctor Hang diagnosed Mr. Tri with a thyroid nodule on the right side measuring 38x27x63 mm, with a low malignant potential. Fat tumor in the left thyroid lobe area, measuring 82x35x84 mm, compresses the thyroid lobe, shifting the trachea to the right, easily mistaken for a large goiter.
According to M.D. Phan Vu Hong Hai, Department of Thoracic and Vascular Surgery, Tam Anh General Hospital, Ho Chi Minh City, most lipomas form under the skin, are easy to see and feel, so they are easy to diagnose in the early stages. . As for Mr. Tri’s lipoma, it was located right in the thyroid lobe and was very difficult to recognize when it first formed. “It is rare for lipomas to reach a size of 8-9 cm because usually under 3 cm, surgery is indicated,” said Dr. Hai.
The patient’s neck area was swollen due to lipoma and goiter. Image: Tam Anh Hospital
The most effective treatment method is to remove the lipoma in the right lobe of the thyroid gland to avoid the risk of respiratory failure, according to Dr. Hang. Large goiter surgery is difficult, can easily cause bleeding complications, and changes in the anatomical structure of the neck. After nearly three hours, the surgery was successful.
On the first day after surgery, the patient did not experience hoarseness or hand numbness, and symptoms of shortness of breath improved significantly. He was discharged from the hospital after three days, and pathology results confirmed that the goiter was benign.
Dr. Hang advised Mr. Tri on how to care for the surgical wound, diet, and activities on the day of his follow-up examination. Image: Ha Vu
Lipomas grow slowly and do not spread (metastasize), have a genetic tendency, and are more common at the age of 40-60. The way to reduce the risk of developing lipomas is to eat scientifically, exercise regularly, limit sugar intake, and regularly check the body to detect tumors early. When you feel a tumor, you should go to the hospital so the doctor can determine if the tumor is benign or malignant. After lipoma removal treatment, patients need to be re-examined according to the doctor’s instructions.
When the neck area is abnormally enlarged with difficulty breathing, difficulty swallowing, change in voice or hoarseness, the patient needs to be screened for thyroid disease. Women 30 years of age or older or those with a family history of thyroid disease should have regular check-ups and thyroid function tests.