Management of Retrosternal Goitres

Large posterior mediastinal retrosternal goiter managed by a transcervical and lateral thoracotomy approach

“…1,2,4,5 However, primary mediastinal goiter, which arises from an ectopic mediastinal goiter, is rare (1%) and, importantly, receives a separate blood supply originating from mediastinal vessels including the internal mammary artery, innominate arteries, and intrathoracic aorta. 2,4,5 Several classifi cation systems have been reported to categorize substernal goiters. One recent system classifi es goiters as grades 1-4 based on their extent of intrathoracic extension 8 and another classifi es them as grades 1-3 based on their anatomical location and the recommended surgical approach (cervical, manubriotomy, or full sternotomy).…”

“…1,2 Its incidence in the general population, based on mass chest radiographic screening, is reported to be 0.02%-0.5%. 3 However, among patients with a goiter, it is reported to range widely from 2.6% to 30.4% 1,2,4-7 partly due to the ambiguity of description and varying defi nitions of a mediastinal goiter employed in these reports.…”

“…Most are removed through a transcervical approach, but additional incisions are required in 2%-29% of these patients. 1,2,[4][5][6][7] These incisions include manubriotomy, total sternotomy, and lateral thoracotomy. Lateral thoracotomy gives excellent exposure, particularly for a large posterior mediastinal goiter placed retrotracheally with crossover from the left to the right side, as in the case we report.…”

Definition of retrosternal thyroid growth

“…Cohen [7] performed sternotomy in cases with malignancies, growth into the posterior mediastinum and especially in cases with ectopic nodules and tissue below the aortic arch. Cui [8], Hardy [9], and Hsu [10] performed cervicotomy in the majority of patients with retrosternal thyroid growth. Alifano [11] emphasized the value of limited upper sternotomy in patients with thymomas and retrosternal goiters.…”

Transvaginal Probe Application in the Visualization and Evaluation of a Retrosternal Thyroid Mass

“…However retrosternal components of thyroid gland are not easily imaged by traditional ultrasound due to poor penetration and artifact generated by bony structures. That pose significant problem to visualize, correctly assess and sample thyroid nodules within retrosternal thyroid tissue causing exclusion of malignancy difficult [8]. A transvaginal probe is one of several endocavitary ultrasound transducers primarily employed in the fields of gynecology and obstetrics for the purpose of transvaginally examining intrapelvic organs.…”