Massive Calcification in a Giant Nodular Thyroid Disease: A Case Study and Review of the Literature

• Victor Ikechukwu Canice Nwagbara

  Department of Surgery, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria

• John Adi Ashindoitiang

  Department of Surgery, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria

• Theophilus Ipeh Ugbem

  Department of Pathology, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria

• Ola Matthias Ekpenukpang

  Department of Pathology, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria

• Nna Okorn Obeten

  Department of Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria

• Maurice Efana Asuquo

  Department of Surgery, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria

A thyroid nodule is characterized as a discrete lesion, distinguishable from the adjacent thyroid parenchyma, and is frequently encountered in clinical settings. Currently, the terminology "nodular disease of the thyroid" is advised for use in both clinical and pathological classifications due to its expansiveness. Individuals with longstanding multinodular goitres are at risk for cystic degeneration, haemorrhaging, and dystrophic calcification. The main aim of this report is to assess the potential risk of cancer, mitigate the chances of obstructive symptoms and formulate a strategy for a secure and efficient surgical procedure. This paper presents a case involving a 68-year-old female patient who reported an anterior neck mass persisting for 35 years. Clinical assessments, imaging studies, and pathological examinations indicated extensive calcification within a giant nodular thyroid disease, which exerted pressure on the colloid goitre, reducing it to a thin peripheral layer without atypical features. The distinct contribution of this case is the emphasis on the uncommon nature of this presentation, and the associated diagnostic uncertainty, despite the presence of extensive macrocalcification, which still raises concerns about malignancy and necessitates thorough examination. Additionally, it underscores the notable surgical difficulties posed by the density, size, and potential adherence of the calcified tissue to adjacent structures. Key clinical insights reveal that imaging plays a vital role in surgical planning, that the prevention or alleviation of symptoms is an important outcome and that histopathological analysis remains the gold standard for diagnosis. The occurrence of extensive calcification in such a condition is uncommon. Effective collaboration among clinicians, radiologists, and pathologists is essential for accurate diagnosis and informed decision-making regarding thyroid nodular disease. Early diagnosis and intervention for nodular thyroid conditions are advocated, as advancing lesions may lead to compressive complications.

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