Long-standing anterior neck swelling, slowly progressing in size.
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Asymmetric multinodular enlargement of the thyroid gland with the right lobe larger than the left cranially extending just to the inferior margin of the hyoid, caudally stopping short of the top of the manubrium. It is displacing and compressing the tracheal air column. No significant lymphadenopathy.
A typical case of a large multinodular goiter. It is important to look for retrosternal extension and extent of airway compression.