Abstract
A 60-year-old woman presented with an enlarging goitre associated with a 9-month history of dysphagia, hoarseness, heat intolerance, palpitations and weight loss. Physical examination revealed an enlarged right thyroid gland, 8 cm × 4 cm, soft, with no associated cervical lymphadenopathy. Her pulse rate was 90 BPM, regular. She had no eye signs, tremor or sweaty palms. Thyroid function tests showed free thyroxine (fT4) of 7.75 pmol/L (normal: 12.00–22.00 pmol/L) and TSH < 0.005 mU/L (normal: 0.27–4.20 mU/L). A repeat sample to check triiodothyronine (T3) level showed elevated free T3 level at 7.71 pmol/L (normal: 3.1–6.8 pmol/L) confirming …
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