Evidence map›Paper›PMID 40355872›Full record

ReviewBMC endocrine disorders2025

Unusual nodular goiter with recurrent laryngeal nerve palsy due to severe degeneration caused by intense chronic inflammation: a case report with histopathological evidence and review of the literature.

Ryo Takagi, Kosei Mori, Sayumi Tsuyuguchi, Takashi Koike, Dinh Nam Nguyen, Kengo Kanai, Yoshihiro Watanabe, Mitsuhiro Okano, Yoshihiro Noguchi, Yuichiro Hayashi and 1 more

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In one paragraph

Review in BMC endocrine disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Ryo TakagiDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Narita Hospital, Narita, Japan.
Kosei MoriDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Narita Hospital, Narita, Japan.
Sayumi TsuyuguchiDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Narita Hospital, Narita, Japan.
Takashi KoikeDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Narita Hospital, Narita, Japan.
Dinh Nam NguyenDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Narita Hospital, Narita, Japan.
Kengo KanaiDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Narita Hospital, Narita, Japan.
Yoshihiro WatanabeDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Narita Hospital, Narita, Japan.
Mitsuhiro OkanoDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Narita Hospital, Narita, Japan.
Yoshihiro NoguchiDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Narita Hospital, Narita, Japan.
Yuichiro HayashiDepartment of Pathology, School of Medicine, International University of Health and Welfare, Narita Hospital, Narita, Japan.
Yorihisa ImanishiDepartment of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Narita Hospital, Narita, Japan. yorihisa@ja2.so-net.ne.jp.

Funding

Grant-in-Aid for Scientific Research (C) from The Japan Society for the Promotion of Science 23K08918
6 · The paper itself

Abstract

backgroundThyroid tumors presenting with recurrent laryngeal nerve (RLN) palsy are generally considered malignant; however, RLN palsy has been reported even in benign thyroid disease (BTD), mainly due to compression or stretching, although seemingly quite rare. Herein, we report an unusual case of nodular goiter that was extremely difficult to differentiate preoperatively from thyroid malignancy because of the concomitant ipsilateral RLN palsy caused by chronic inflammation. CASE PRESENTATION: A 59-year-old Japanese female presented with hoarseness and pharyngeal discomfort. Endoscopic examination revealed fixation of the right vocal cord, presumably due to right RLN palsy. Ultrasonography and computed tomography showed an ill-defined thyroid mass lesion in the right lobe, strongly suggestive of malignancy, although repeated aspiration cytology revealed no suspicion of malignancy. Intraoperatively, because the right RLN was found to be entirely embedded within the hard mass lesion and completely unresponsive to nerve integrity monitoring, the nerve was unavoidably excised along with the right lobe. Histopathology led to the final diagnosis of nodular goiter, wherein the resected RLN was severely degenerated and disrupted due to intense chronic inflammation accompanied by perineural fibrosis.

conclusionsOur literature review suggests that RLN palsy associated with thyroid mass lesions should not be considered a definitive indicator of malignancy because it can also be observed in BTD, although it is significantly less frequent than in malignancy as corroborated by our meta-analysis. Even in BTD, if the primary cause of the coexisting RLN palsy is severe chronic inflammation, nerve preservation is potentially unfeasible.

Indexed as

Goiter, NodularInflammationVocal Cord ParalysisChronic DiseaseFemaleHumansMiddle AgedThyroidectomyBenign thyroid diseaseChronic inflammationNerve degenerationNerve resectionNodular goiterRecurrent laryngeal nerve palsyThyroidectomy

Identifiers

PMID40355872
PMCPMC12067666

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.