Hyderabad, Telangana, 19th of September, 2026 : A 37-year-old woman from Sudan with a large 15×10 cm thyroid mass extending from her neck into the chest has been successfully treated at CARE Hospitals, Hitech City, Hyderabad, through a complex repeat surgery made more challenging by an earlier thyroid operation.
The patient had been experiencing swelling in the front of her neck for nearly a year. Seeking specialised treatment, she travelled from Sudan to Hyderabad, where a detailed evaluation at CARE Hospitals revealed significant enlargement of the thyroid. The right lobe measured approximately 15×10 cm and extended into the mediastinum, the central compartment of the chest that houses several vital structures.
Adding to the complexity, the patient had undergone thyroid surgery seven years earlier. Operating for a second time in the same region can be technically demanding, as scar tissue from previous surgery can alter the normal anatomy and make dissection around important structures more challenging.
The extension into the chest required additional surgical planning. While the thyroid gland is normally located in the lower neck, a significantly enlarged thyroid can sometimes grow downwards into the chest. Depending on its size and extent, such a mass can come into close proximity to the airway, oesophagus and major blood vessels and may potentially cause breathing difficulty, swallowing problems, voice changes or pressure-related symptoms.
After detailed evaluation and surgical planning, a multidisciplinary team led by Dr Rahul Reddy Levaka, Senior Consultant Surgical Oncologist, CARE Hospitals, Hi-Tech City, along with Dr Ajay Chanakya and Dr Ramu Damuluri, undertook the procedure, supported by the anaesthesia, nursing and clinical care teams.
The patient underwent a total thyroidectomy under general anaesthesia. The surgical team carefully mobilised and removed the enlarged thyroid, including its mediastinal component, while navigating the challenges posed by the previous surgery and altered tissue planes. The thoracic part of the surgery was performed using VATS (Video-Assisted Thoracoscopic Surgery), allowing the team to carefully separate the thyroid from the critical mediastinal structures, including the major blood vessels, and safely remove the intrathoracic component.
The procedure was completed successfully. The patient remained stable following surgery, recovered well and was subsequently discharged with appropriate follow-up advice.
Commenting on the case, Dr Rahul Reddy Levaka said, “The challenge in this case was not just the size of the thyroid swelling. The patient had already undergone thyroid surgery seven years ago, which meant we were operating in an area with scar tissue and altered anatomy. In addition, a significant part of the thyroid was extending into the chest. This required careful planning and meticulous dissection through minimally invasive Thoracoscopic surgery (VATS) around important structures.”
He added that large thyroid swellings should not be ignored simply because they may initially be painless. “Thyroid swellings can grow slowly and may not cause major symptoms in the beginning. However, as they become larger or extend into the chest, they can potentially put pressure on the airway, food pipe and surrounding structures, making treatment more complex. Not every thyroid swelling is cancerous, but any persistent or increasing neck swelling needs proper medical evaluation,” said Dr Rahul.
The case also highlights the importance of timely assessment, particularly for patients who have previously undergone thyroid surgery. Doctors said that a new or recurrent neck swelling, progressive increase in size, difficulty swallowing, breathing discomfort, persistent voice changes or a feeling of pressure in the neck or chest warrants medical attention.
Dr Pramod Gupta, Chief Operating Officer, CARE Hospitals, Hi-Tech City, said, “Complex cases require much more than a surgical procedure. They need experienced specialists, detailed planning and coordinated multidisciplinary care throughout the patient’s journey. We continue to see patients from India and overseas coming to Hyderabad for specialised treatment. Our focus is to ensure that every patient receives comprehensive care from evaluation and treatment through recovery and follow-up.”
Doctors emphasised that the presence of a thyroid mass does not necessarily indicate cancer. The nature of a thyroid swelling needs to be determined through appropriate clinical evaluation, imaging and, where indicated, pathological examination
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