medigraphic.com
Anales de Otorrinolaringología Mexicana

2023, Number 2

<< Back Next >>

Otorrinolaringología 2023; 68 (2)

Myasthenia gravis and intrathoracic goiter presenting as a combined cause of dysphagia

Guerrero-Paz JA, Pérez-Álvarez CI, Ibarra-Ibarra AD

Language: English
References: 20
Page: 72-79
PDF size: 347.52 Kb.


ABSTRACT

Background: Dysphagia is common among general population. Nevertheless, it is more common among patients with thyroid neoplasms or neurologic disease, presenting as one of the first complaints. Dysphagia characteristics classify and dichotomize its management, often requiring a thorough assessment excluding organic disease.
Clinical case: A 46-year-old male patient with dysphagia produced by extraesophageal compression due to goiter with a neurological spectrum due to myasthenia gravis.
Conclusions: With this case, we highlight the difference between the clinical spectrum of both entities and the characteristics both share.


REFERENCES

  1. Philpott H, Garg M, Tomic D, Balasubramanian S, Sweis R:Dysphagia: Thinking outside the box. World J Gastroenterol 2017; 23: 6942-51. doi: 10.3748/wjg.v23.i38.6942.

  2. Cho SY, Choung RS, Saito YA, Schleck CD, Zinsmeister AR,Locke GR 3rd, Talley NJ: Prevalence and risk factors fordysphagia: a USA community study. NeurogastroenterolMotil Off J Eur Gastrointest Motil Soc 2015; 27: 212-9. doi:10.1111/nmo.12467.

  3. Triggs J, Pandolfino J: Recent advances in dysphagiamanagement. F1000Research 2019, 8. doi: 10.12688/f1000research.18900.1.

  4. Liu LWC, Andrews CN, Armstrong D, Diamant N, et al.Clinical Practice Guidelines for the Assessment of UninvestigatedEsophageal Dysphagia. J Can Assoc Gastroenterol2018; 1: 5-19. doi: 10.1093/jcag/gwx008.

  5. Clavé P, Shaker R: Dysphagia: current reality and scopeof the problem. Nat Rev Gastroenterol Hepatol 2015; 12:259-70. doi: 10.1038/nrgastro.2015.49.

  6. Takizawa C, Gemmell E, Kenworthy J, Speyer R. A systematicreview of the prevalence of oropharyngeal dysphagiain stroke, Parkinson’s disease, Alzheimer’s disease, headinjury, and pneumonia. Dysphagia 2016; 31: 434-41. doi:10.1007/s00455-016-9695-9.

  7. Eng OS, Potdevin L, Davidov T, Lu S-E, Chen C, TrooskinSZ: Does nodule size predict compressive symptoms inpatients with thyroid nodules? Gland Surg 2014; 3: 232-6.doi: 10.3978/j.issn.2227-684X.2014.08.03.

  8. Ambe P, Lindecke K, Knoefel WT, Rehders A. Cervicalcompression due to benign thyroid disorders is notassociated with increased postoperative morbidity. EurArch Otorhinolaryngol 2015; 272: 2457-61. doi: 10.1007/s00405-014-3193-1.

  9. Juanpere S, Cañete N, Ortuño P, Martínez S, SanchezG, Bernado L. A diagnostic approach to the mediastinalmasses. Insights Imaging 2013; 4: 29-52. doi: 10.1007/s13244-012-0201-0.

  10. Carter BW, Benveniste MF, Madan R, Godoy MC, etal. ITMIG classification of mediastinal compartmentsand multidisciplinary approach to mediastinal masses.RadioGraphics 2017; 37: 413-36. doi: 10.1148/rg.2017160095.

  11. Tsilimigras DI, Patrini D, Antonopoulou A, Velissaris D,Koletsis E, Lawrence D, Panagiotopoulos N. Retrosternalgoitre: the role of the thoracic surgeon. J Thorac Dis 2017;9: 860-3. doi: 10.21037/jtd.2017.02.56.

  12. Pace-Asciak P, Higgins K. Management of intrathoracicgoitre. Can J Surg 2008, 51: E111-2.

  13. Rui Sheng Y, Chong Xi R. Surgical approach and techniquein retrosternal goiter: Case report and review of theliterature. Ann Med Surg 2016; 5: 90-2. doi: 10.1016/j.amsu.2015.12.057.

  14. George RA, Godara SC, Singh H, Bhagat HK. Rare presentationof an intrathoracic goiter. Med J Armed Forces India2007; 63: 77-9. doi: 10.1016/S0377-1237(07)80120-1.

  15. Chira RI, Chira A, Mircea PA, Valean S. Mediastinal massestransthoracicultrasonography aspects. Medicine (Baltimore)2017; 96: e9082. doi: 10.1097/MD.0000000000009082.

  16. Vaiman M, Bekerman I, Basel J, Peer M. Surgical approachto the intrathoracic goiter. Laryngoscope Investig Otolaryngol2018; 3: 127-32. doi: 10.1002/lio2.146.

  17. Sahbaz NA, Tutal F, Aksakal N, Acar S, Aksu KI, Barbaros U, ErbilY. Cancer frequency in retrosternal goiter. Am Surg 2017;83: 1390-3. https://doi.org/10.1177/000313481708301224.

  18. Gilhus NE, Tzartos S, Evoli A, Palace J, Burns TM, VerschuurenJJGM. Myasthenia gravis. Nat Rev Dis Prim 2019; 5: 30.doi: 10.1038/s41572-019-0079-y.

  19. Ettinger DS, Riely GJ, Akerley W, Borghaei H, et al. Thymomasand thymic carcinomas: Clinical Practice Guidelines inOncology. J Natl Compr Canc Netw 2013; 11: 562-76. doi:10.6004/jnccn.2013.0072.

  20. Jovanovic D, Bilaceroglu S. Revealing the mysteries ofthymoma. J Thorac Dis 2020; 12: 7515-7. doi: 10.21037/jtd-2019-thym-15.




2020     |     www.medigraphic.com