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3D Printed Multinodular Goitre
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3D Printed Multinodular Goitre
Clinical Presentation
A 53-year-old female presented with an abnormal swelling in the neck and a
persistent cough. She complained of lethargy and weight gain over the previous few years. Whilst being investigated
she died of unrelated cardiovascular disease several months later.
Pathology
The specimen, removed at post-mortem, includes the base of the tongue, larynx and
trachea. It has been cut in the coronal plane to allow a view of the internal laryngeal and tracheal anatomy. The
thyroid gland is grossly enlarged particularly the right lobe, which extends superiorly and inferiorly, well beyond
its normal margins when viewed from the anterior aspect. The cut posterior surfaces display many hyper- and
hypopigmented nodules as well as cystic areas in both lobes. The tongue base, larynx and trachea appear relatively
normal.
Further information
Nodular goitre is most often detected simply as a mass or swelling in the
neck but depending on size and location of growth may produce pressure symptoms on the trachea and the oesophagus.
There may be difficulty in breathing, dysphagia, cough, and hoarseness. Paralysis of the recurrent laryngeal nerve
may occur by an expanding goitre, but this is rare. Symptoms suggesting obstruction of the trachea including cough,
stridor and shortness of breath may occur. Occasionally tenderness and a sudden increase in goitre size arise due to
cystic expansion or haemorrhage into a nodule[1].
Causes of goitre include autoimmune disease (Hashimoto’s thyroiditis, Grave’s disease), the formation of one or more
thyroid nodules and iodine deficiency. Goitre occurs when there is reduced thyroid hormone synthesis secondary to
biosynthetic defects and/or iodine deficiency, leading to increased thyroid stimulating hormone (TSH). This
stimulates thyroid growth as a compensatory mechanism to overcome the decreased hormone synthesis. Elevated TSH is
also thought to contribute to an enlarged thyroid in the goitrous form of Hashimoto thyroiditis in combination with
fibrosis secondary to the autoimmune process in this condition. In Grave’s disease, the goitre results mainly from
stimulation by the TSH receptor antibody[1].
Reference
1. Hughes et al. (2012) Goitre: Causes, investigation
and management. Aust Family Physician, 41, 572-576.
GTSimulators by Global Technologies
Erler Zimmer Authorized Dealer
The models are very detailed and delicate. With normal production machines you cannot realize such details like shown in these models.
The printer used is a color-plastic printer. This is the most suitable printer for these models.
The plastic material is already the best and most suitable material for these prints. (The other option would be a kind of gypsum, but this is way more fragile. You even cannot get them out of the printer without breaking them).The huge advantage of the prints is that they are very realistic as the data is coming from real human specimen. Nothing is shaped or stylized.
The users have to handle these prints with utmost care. They are not made for touching or bending any thin nerves, arteries, vessels etc. The 3D printed models should sit on a table and just rotated at the table.