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Case Reports
. 2012 Nov;15(5):935-7.
doi: 10.1093/icvts/ivs339. Epub 2012 Aug 23.

Retrosternal goiter located in the mediastinum: surgical approach and operative difficulties

Grzegorz Kacprzak  1 , Jacek Karas, Adam Rzechonek, Piotr Blasiak
Affiliations
Case Reports

Retrosternal goiter located in the mediastinum: surgical approach and operative difficulties

Grzegorz Kacprzak et al. Interact Cardiovasc Thorac Surg. 2012 Nov.

Abstract

Most retrosternal goiters are situated in the anterior mediastinal compartment, but according to the literature, 10-15% are located in the posterior mediastinum. Although most of the anterior mediastinal goiters can be removed by a transcervical approach, posterior mediastinal goiters may require additional extracervical incisions. We report the case of a huge posterior mediastinal goiter extending from the neck retrotracheally beyond the aortic arch and azygous vein with crossover from the left to the right side and ending at the level of the lower part of the left cardiac atrium, nearly reaching the diaphragm. Surgical removal is the treatment of choice in such cases. We performed an operation using a transcervical and right thoracotomy approach. Histopathological examination confirmed the diagnosis of the large goiter. The patient recovered well and was discharged in 1 week.

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Figures

Figure 1:
Figure 1:
(A) Preoperative axial CT scan showing a large retrosternal goiter located in the mediastinum. (B) Preoperative sagittal (left) CT scan showing a large retrosternal goiter located in the mediastinum. (C) Preoperative SPECT/CT scan using J131, which showed that the big mass on the neck and in the mediastinum corresponded to the huge thyroid gland.
Figure 2:
Figure 2:
Complete retrosternal goiter after surgical resection.
See this image and copyright information in PMC

References

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