13517              THYROID ATROPHY - MYXOEDEMA

A butcher aged 60 had a 2 year history of fatigue, weakness, apathy and inclination to sleep rather than work.  He therefore sold his business.  He had gained weight, his voice had become hoarse and he disliked cold weather.  On examination the skin was soft and pale, facial hair scanty, axillary hair absent and there was marked reduction of hair on the chest, pubes and limbs.  Investigation showed low protein-bound iodine, deficiency in ketogenic and ketosteroid urinary levels and a low voltage ECG.  Before treatment could be commenced he developed acute pain in the chest with very low BP and gross peripheral circulatory failure with some ventricular extrasystoles.  He died 3 hours later.  At postmortem the pituitary, adrenals, pancreas and testes were of normal size, but the thyroid was atrophic.

The specimen consists of the larynx and the upper few cms of the trachea together with the thyroid gland.  The thyroid is small, pale, shrunken, fibrous and infiltrated by fat.