Posterior mediastinal goiters: Report of two cases and literature review

Abstract

Intrathoracic goiters represent substantial enlargement and descent of cervical thyroid tissue into the thoracic cavity, usually in the anterior mediastinum. Rarely, they extend posteriorly, causing obstructive symptoms, sometimes with acute onset. Posterior mediastinal goiters should be differentiated from other mediastinal masses by appropriate work-up, while computed tomography is the most valuable technique. We report two cases of such symptomatic goiters. First reported case was atypically presented with aspiration pneumonia and second was successfully operated. Our overview aims to increase awareness of this rare clinical entity due to possible respiratory compromise. Reasonable surgical management is mandatory.

Cervical Approach of a Posterior Mediastinal Goiter: A Case Report

“…Selective approach: thoracotomy, combined cervicothoracic approach is advocated for larger lesions, when mass is intrathoracic, no cervical component, or when mass is malignant. 11,12 The successful cervical excision is the highlight in this case, avoiding the significant morbidity of combined approaches/thoracotomies. Thoracotomy is associated with severe postoperative pain, infection, basal lung collapse, and respiratory failure, which had been totally avoided in our patient.…”

Intrathoracic goitre associated with pulmonary tuberculosis

“…The patient died due to severe gram negative sepsis. 15 Association of goitre with pulmonary tuberculosis seems to be rare. In the pre-chemotherapeutic era, pulmonary tuberculosis with pleural effusion was documented in a pregnant female.…”

Seorang Penderita dengan Retrosternal Goiter

“…Sistematik review menunjukkan 5-10% operasi retrosternal goiter dilakukan pada kasus rekurans atau persistent. 11,15 Pada kasus ini, penderita seorang wanita dengan usia 56 tahun, dengan hasil histopatologi kelenjar tiroid jinak. Penderita tidak pernah mengalami pembesaran kelenjar tiroid sebelumnya, tidak ada riwayat keganasan.…”

“…Retrosternal goiter pada umumnya eutiroid, tetapi dapat ada juga yang menunjukkan gejala hipertiroid dan tirotoksikosis tetapi jarang sekali hipotiroid. 10,14,15 Pada kasus ini gejala klinis yang dominan pada pasien adalah nyeri dada, sesak napas hanya bila beraktivitas berat. Nyeri dada pada penderita karena massa tiroid yang besar menyebabkan kompresi pada sistem saraf.…”