Retrosternal extension of goiter is one of the most common types of masses in the superior mediastinum. These types of goiters classically present with compressive symptoms such as dyspnea, dysphonia, dysphagia, or sleep apnea. Surgical treatment with a total thyroidectomy and complete removal of the intrathoracic portion of thyroid is the gold standard treatment. These cervicomediastinal lesions at times may not be continuous, and a sternotomy may be required for complete and safe excision of the mediastinal mass to achieve decompression of the surrounding structures and preventing the hemorrhagic complications if attempted from cervical incision. We present a summary of two cases that gave an initial impression of retrosternal extension of thyroid gland, however intraoperatively were found to be separately encapsulated and required sternotomy for its safe and complete excision.

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Highlights Wet labs are a useful, cost-effective and safe tool in teaching of Cardiothoracic Surgery residents. In a third world country where advance real life simulators are not available. It improves resident's tissue handling and surgical skills. Allows faculty members to give continuous feedback to their residents.

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Highlights 11 year old child who presented with effusive Constrictive Pericarditis. Required urgent Pericardiectomy for managing right heart failure. Histopathology showed Anaplastic Large Cell Lymphoma.