This patient with amyloid goiter had secondary paralysis of the vocal cords without bulky laryngeal lesions. Amyloid infiltration of the perilaryngeal tissues with secondary fibrosis involved the recurrent laryngeal nerves. In addition, amyloid involvement of the cricopharyngeus muscle caused improper deglutition and aspiration. This was relieved with cricopharyngeal myotomy. The distinguishing aspects of this case and amyloid goiter are compared and contrasted with amyloidosis as a disease entity. The striking clinical feature of amyloid goiter is its rapid growth. Exacting pathological evaluation of tissue samples are necessary to make the correct diagnosis. Amyloid goiter must be differentiated from thyroid carcinoma, Reidel's struma, granulomatous thyroiditis, and the fibrous type of struma lymphomatosa.
Shapiro ST, Kohut RI, Potter JM. Amyloid Goiter: New Associations and Surgical Treatment. Arch Otolaryngol. 1971;93(2):203–208. doi:10.1001/archotol.1971.00770060289019
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