CASE REPORT

Struma Nodusa non Toxic

By:

Bilqis Nabilah
Indriyati Januar T
Muhammad Nizar N K
Irman Saputra
Tangguh Wili Andyry
Patient Information
● Name : Mrs. Siyamlah
● DOB : 50 years old (25 July 1970)
● Address : Jl. Terunojoyo Cinta Rakyat Dsn
XI
● Occupation : housewife
● Religion : Islam
● Room : Jabal Rahmah A.8
● MR : 364815
● DOE : 09/07/2021
 Case Report

A 50 years old woman arrived at the emergency department Medan Hajj Hospital with
complaints of a lump on the right neck since 2 months ago. She also complaining of
fatigue, restless, dyspnea, dysphagia, itching, anorexia, weight loss. The patient was free of
nausea, vomiting, fever, tachycardia, sweating, and tremor.

No history of medication, family health, and medicine usage.

 Diagnostic Physical
Examination
– General condition : Moderate

– Awareness : Allert

– Blood pressure : 140/80 mmHg

– Pulse : 76 bpm

– Temperature : 36 ⁰C

– Respiration : 20 bpm

– SPO2 : 98% ROOM AIR

 Diagnostic Physical Examination
Head: Normocephali
Eyes: CA -/-, SI -/- , isochoric pupils +/+

Localization Status : Neck

Neck: Lump on the right (+)
• inspection : there is a lump in the colli area (R), the surface is flat, and well defined.
• Palpation : the consistency is rubbery, mobile, painful (-), with a size of 6cm x 3cm.

Nuchal rigidity (-), normal JVP

Thorax : Rh -/-, Wh -/-
Abdomen : Soepel (+), Symetric (+), tenderness (-)
Extremity : CRT < 2, oedem (-)
Chlinical Pathology Laboratory
Hematology

No. Examination Result Normal Unit

1 Erythrocytes 5.02 4.00-5.-- g/dL
2 Total Lymphocytes 2.96 thousand/uL
3 Total Basophil 0.01 thousand/uL
4 Total Monocytes 0.44 50-300 thousand/uL
5 Random Glucose 65 <200 mg/dL
- Thyroid Profile
1 T3 1.1 0.9-2.3 Nmol/l
2 T4 6.0 4.6-9.3 Ug/dl
3 TSH 0.31 0.27-5 uUI/mL
ANAMNESA : Resume
GC : 50 years old woman come with complaints of
a lump on the right neck.

HPI : The Patient came with complaints of a lump on the

right neck since 2 months ago. There is a lump in the colli
region (R), with a rubbery consistency, flat surface, mobile,
well-defined, painful (-), and the size is 6cm x 3cm. She also
complaining of fatigue, restless, dyspnea, dysphagia, itching,
anorexia, weight loss.
Diagnosis
Working Diagnosis
Struma Nodusa Non Toxic

Differential Diagnosis

1. Struma Nodusa Toxic

2. Struma Diffusa
3. Thyroid Cancer
TREATMENT
Surgical Therapy

Isthmulobectomy
 Complications
- superior thyroid artery bleeding
- Dyspnea
- Laryngeal nerve paralysis
This nerve serves to innervate the muscles of the larynx. If
damaged, paralysis occurs.
- Superior laryngeal nerve paralysis
As a result, the patient's voice becomes weaker and it is
difficult to control high-pitched voices, due to shortening of
the vocal cords due to relaxation
- Tracheomalacia/trachea collapse
It is the softening of the tracheal cartilage. This cartilage is
shaped like a ring and forms the walls of the trachea. As it
softens, adjacent organs can compress the trachea.
Haemorrhagia
 Prognosis
The prognosis is dubia ad
bonam
Documentation
Thank You 