A rare case of huge retrosternal goiter
DOI:
https://doi.org/10.18203/2349-2902.isj20195427Keywords:
Retrosternal, Sternotomy, Multinodular, GoiterAbstract
Retrosternal goiter is defined when more than or equal to 50% of the thyroid mass is below the thoracic inlet. A median sternotomy approach is required in selected cases especially those presenting with long standing history and radiological assessment is suggestive of thoracic component larger than thoracic inlet. The case reported by us was a 65 year old lady with huge retrosternal goiter with history of dyspnea. Her contrast-enhanced computed tomography neck and thorax suggested diffuse enlargement of both lobes with mediastinal extension and pressure effects in the form of luminal narrowing of trachea. A total thyroidectomy was performed with median sternotomy. No post-operative complications occurred and patient was discharged on 6th post-operative day. Histopathology suggested multinodular goiter.
References
Haller A. Disputatones Anatomica Selectae. Gottingen: Vendenhoceck; 1749: 96.
de Souza FM, Smith PE. Retrosternal goiter. J Otolaryngol. 1983;12:393-6.
Katlic MR, Wang CA, Grillo HC. Substernal goiter. Ann Thorac Surg. 1985;39:391-9.
Newman E, Shaha AR. Substernal goiter. J Surg Oncol. 1995;60:207-12.
Hedayati N, McHenry CR. The clinical presentation and operative management of nodular and diffuse substernal thyroid disease. Am Surg. 2002;68:245-51.
Nervi M, Iacconi P, Spinelli C, Janni A, Miccoli P. Thyroid carcinoma is intrathoracic goiter. Langenbecks Arch Surg. 1998;383:337-9.
Casella C, Pata G, Cappelli C, Salerni B. Preoperative predictors of sternotomy need in mediastinal goiter management. Head and Neck. 2010;32:1131-5.
Mack E. Management of patients with substernal goiters. Surg Clin North Am. 1995;75:377-94.
Coskun A, Yildirim M, Erkan N. Substernal goiter: when is a sternotomy required?. Int Surg. 2014;99(4):419-25.
Hunis CT, Georgalas C, Mehrzad H, Tolley NS. A new classification system for retrosternal goiter based on a systematic review of its complications and management. Int J Surg. 2008;6(1):71-6.
Quadbeck B, Pruellage J, Roggenbuck U, Hirche H, Janssen OE, Mann K, et al. Long-term follow up of thyroid nodule growth. Exp Clin Endocrinol Diabetes. 2002;110:348-54.
Winbladh A, Jarhult J. Fate of the non-operated, non-toxic goiter in a defined population. Br J Surg. 2008;95:338-43.