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. 2024 Jun 21;19(1):350.
doi: 10.1186/s13019-024-02831-7.

Surgical management of anterior mediastinal tumors of thyroid origin: a comprehensive analysis of approaches, techniques, and outcomes

Georgi Yankov  1 , Magdalena Alexieva  1 , Yordanka Yamakova  2 , Dimitar Kyuchukov  3 , Evgeni Mekov  4
Affiliations

Surgical management of anterior mediastinal tumors of thyroid origin: a comprehensive analysis of approaches, techniques, and outcomes

Georgi Yankov et al. J Cardiothorac Surg. .

Abstract

Background: This manuscript aims to describe the symptoms, demographics, surgical approaches and techniques, the volume of surgical interventions, histological results, intra- and postoperative complications, and postoperative results in patients with anterior mediastinal tumors of thyroid origin (AMTTO).

Methods: Twenty patients with AMTTO were operated between 2017 and 2021. Fifteen were women and 5 were men. The mean age was 66.8 years.

Results: The most common histology was nodular micro- and macrofollicular goiter (15/20, 75%). Kocher cervicotomy (65%) was the preferred approach. Total thyroidectomy was performed in 95% of patients. Intraoperative complications were identified in 25% (5/20), and in 2 patients a tracheostomy was required. Early postoperative complications were established in 65% and the most common was unilateral transient recurrent nerve paresis or paralysis and dysphonia (25%).

Conclusions: Commonly resection of AMTTO is a challenge due to its complexities associated with high-risk cases, emphasizing the need for experienced centers in managing such cases.

Keywords: Anterior mediastinal thyroid tumors; Approaches; Complications; Histology; Surgical treatment.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Symptoms in patients with AMTTO
Fig. 2
Fig. 2
CT scan revealing a retrosternal goiter. A Axial image. B Sagittal image
Fig. 3
Fig. 3
Intraoperative images. A Collar neck incision and proximal partial sternotomy with the left thyroid lobe mobilized. B A view after performing total thyroidectomy for nodular goiter (truncus brachiocephalicus was hanged on a tourniquet)
Fig. 4
Fig. 4
Postoperative specimens. A Retrosternal nodular goiter—right and left lobes. B Recurrent malignant mediastinal paraganglioma of thyroid origin
Fig. 5
Fig. 5
Intraoperative complications
Fig. 6
Fig. 6
Early postoperative complications
See this image and copyright information in PMC

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