Background: Goiter sometimes has retrosternal extension in the mediastinum. And may present with compressive symptoms such as dyspnea, dysphagia, dysphonia or sleep apnea. Treatment of choice is total thyroidectomy and removal of the intrathoracic portion of thyroid. However, these cervicomediastinal masses may be separately encapsulated, 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