Giant Cervical Goiter With Posterior Mediastinal Extension

Abstract

Most cervico-mediastinal goiters are situated in the anterior mediastinal compartment, but according to the literature, 10–15 percent of them are located in the posterior mediastinum. Although most anterior mediastinal goiters can be removed by using the transcervical approach, cervico-mediastinal goiters in the posterior mediastinal may require additional extracervical incisions. We report the case of a huge cervico-mediastinal goiter extending from the neck retrotracheally to the posterior mediastinum. Surgical removal is the treatment of choice in such cases. We performed an operation using a transcervical and right posterolateral thoracotomy approach. Histopathological examination confirmed the diagnosis of a large toxic goiter. The patient recovered well and was discharged in one week. While most retrosternal goiters can be resected through a transcervical approach, those extending beyond the aortic arch are better dealt with by either sternotomy or thoracotomy. This report describes the use of transcervical and posterolateral thoracotomy with an excellent postoperative result.

Management of a Long-Standing Huge Goiter During a Humanitarian Mission: A Case Report

“…In these places, the management of giant goiters often comes up against a diagnostic delay, a lack of qualified human resources, and an insufficient technical platform [ 2 , 3 , 5 , 6 ]. This was the case of our patient who lives in a remote area of a sub-Saharan African country marked by difficult access to healthcare facilities.…”

“…Giant goiters can still be encountered in goiter-endemic areas [1][2][3]. These enormous goiters exceeding 500 grams are extremely rare and often found in sub-Saharan Africa and in some Asian countries [1][2][3].…”

“…Giant goiters can still be encountered in goiter-endemic areas [1][2][3]. These enormous goiters exceeding 500 grams are extremely rare and often found in sub-Saharan Africa and in some Asian countries [1][2][3]. Their occurrence in developing countries increases the complexity of the management [4].…”

“…However, in developing countries, due to delayed diagnosis and lack of qualified human resources, surgical management of these goiters remains challenging [ 1 - 3 ]. Here, the authors report a case of endemic giant goiter operated during a humanitarian mission.…”

Giant tumors of the posterior mediastinum: a narrative review of surgical treatment

“…In posterior mediastinal tumors, follow-up is defined by the tumor histopathology, whereas malignant tumors require adjuvant treatment and close follow-up for the early detection of local or distant recurrences, benign tumors do not ( 6 , 8 , 15 ). Although schwannoma, one of the peripheral nerve sheath tumors, may grow significantly, tumors of this kind tend to be benign and generally do not recur ( 18 ).…”