A 64-year-old man was referred for agriculture in a rural area.
In May 2006, the patient was referred to an endocrinology clinic with a diagnosis of symptomatic calcified goiter.
He had a neck x-ray showing an image calcified at the level of the left thyroid lobe.
He reported a history of hypertension under treatment and a puncture of a thyroid nodule 18 years ago, in which clear fluid was aspirated.
Medical history revealed dyspnea on exertion and dysphagia for one year.
On examination, a hard, painless, left supraclavicular mass was infiltrated, which was projected towards the thorax.
Her thyroid profile and blood count were normal.
A chest X-ray showed a calcified intrathoracic image, displacing the trachea and aorta to the right.
Thyroid scintigraphy revealed a large cold nodul in the 2/3 Left lobe Inferiors.
Computed tomography (CT) of the neck and chest revealed a nodule in the upper mediastinum of thyroid origin (suggesting calcified adenoma) with displacement of the airway and vessels and a small right nondulla.
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With the diagnosis of symptomatic intrathoracic multinodular goiter, he was sent to the surgery service for resolution of his pathology, where it was decided to perform a thyroidectomy.
In the cervical exploration it was found that the left lobe of the thyroid was practically replaced by a calcified nodul, 8x6x6 cm, projected mostly to the mediastinum, and there was another nondulous right lobe.
No regional lymphadenopathy was found.
An almost total thyroidectomy was performed with glandular remnant at the level of the right posterior capsule.
Deferred biopsy reported that the nodule of the left lobe corresponded to a calcified hydatid thyroid cyst with foci of ossification and the right node to a focal nodular hyperplasia of the thyroid.
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Hydatid disease was reported and an abdominal ultrasound was performed, which showed no images suggestive of hydatid cyst.
Seven months after surgery, the patient remains asymptomatic and has no clinical or radiological evidence of recurrence or hydatid disease in other organs.
