Intrathoracic goitre is defined as goitre in which at least 50% of the thyroid mass lies below the thoracic inlet. Here we report the case of a 43-year-old female, with history of left thyroid lobectomy 15 years earlier, who presented with dyspnoea. CT scan showed huge bilateral intrathoracic masses. Through median sternotomy, the masses were successfully excised, though with difficulty due to their hypervascular nature, along with completion thyroidectomy. Histopathology of the specimens showed multinodular goitre with no evidence of malignancy. The patient recovered well and one year after discharge, delivered a healthy baby. Highlights:

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To report the outcome of simultaneous bilateral nephrectomy (SBN) and living donor renal transplantation (LDRT) for Autosomal Dominant Polycystic Kidney Disease (ADPKD) in our center.Methods: retrospective comparative chart review study between ADPKD patients who underwent SBN and LDRT (group A) and ADPKD patient who underwent LDRT only (group B) at our center.Results: From May 2010 to August 2017, 7 patients in group A and 15 patients group B were included. Males represented 86% of both groups. Mean patient age (years) and body mass index (BMI) were 46.4 ± 7.6, 27.2 ± 6.9 vs. 43.1 ± 6.9, 25.6 ± 4.2 in groups A and B, respectively. Most common indications of SBN were abdominal discomfort and pain (100%); surgeons indicated loss of abdominal domain (57%), early satiety (28%) and hematuria (28%). All patients received kidney from living donors. Mean operative time and estimated blood loss were 379.8 ± 24min, 130.7 ± 15 vs. 464 ± 30 ml, 170 ± 10 in groups A and B respectively. Average length of stay(days) was 9.4 ± 1 and 7.8 ± 1.1 in groups A and B respectively. All patients had immediate graft function with average serum creatinine(mmol/l) on discharge, one month and last follow up were 85.6,78.6,81 vs. 77 ± 17,84 ± 12,93 ± 8 in groups A and B, respectively. There was no mortality, rejections, wound complications, collections or reoperation in both groups. One year graft and patient survival in both groups was 100%. Conclusion:SBN and LDRT is an acceptable alternative to a conventional two stage procedure without added morbidity and without significant negative impact on patient and graft survival, obviating the need for a separate procedure.