Management of substernal goiter

Abstract

Despite the large size of these goiters and the significant involvement of the major mediastinal structures, all were approached through the transcervical incision. Further, despite significant tracheal involvement, there were no cases of tracheomalacia or major complications. For intraoperative planning, the authors advocate the routine use of preoperative computed tomography scanning.

Avaliação crítica de 33 pacientes com bócio mergulhante tratados cirurgicamente por cervicotomia

“…Prevalence rates of substernal goiter range between 1% and 21% of goiter cases [3][4][5][6][7][8][17][18][19] ; in spite of being a relatively frequent finding, clinical diagnosis is not always obvious.…”

“…They have had goiter for a long time, and only seek medical advice when symptoms kick in. Compressive complaints such as dyspnea are reported by 16-65% 3,6-9,19,20 of the patients; dysphagia by 4-27% 3,6,9,19,20 ; and presence of neck mass by 35-100% 3,[7][8][9][10]20 . Hyperthyroidism is reported in about 13% of the cases 3,10 .…”

“…The need for sternotomy or thoracotomy ranges between 0% and 13% [3][4][5][7][8][9][10][11][12][13][14]17,19 ; one author reported rates of 29% 7 .…”

“…20 Malignancy rates associated with substernal goiter range between 4 and 16% [6][7][8][9][10]13,19,20 . Six percent of the patients in our group were diagnosed with well differentiated tumors.…”

Images in endocrinology: multinodular goitre

“…This lowly growing of the goitre, compress in years surrounding tissue as veins, giving time to create superficial venous collaterals (5). The treatment of clinical complicated goitre is surgery, since the complications a relatively rare (6).…”