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Article: A Monster in the Chest: A Tale of a Goiter.

Sandasecra, Sanjeev / Yahya, Maya Mazuwin / Zuhdi Mamat, Ahmad / Soh, Jien Yen / Ramely, Rosnelifaizur / Aziz, Mohd E

Cureus

2022  Volume 14, Issue 6, Page(s) e25827

Abstract: Substernal goiter is usually presented in elderly patients and is mostly asymptomatic. A large substernal goiter is surgically challenging and can be managed through a transcervical incision and sternotomy. This case report is about a large substernal ... ...

Abstract Substernal goiter is usually presented in elderly patients and is mostly asymptomatic. A large substernal goiter is surgically challenging and can be managed through a transcervical incision and sternotomy. This case report is about a large substernal goiter extending into the anterior mediastinum and causing superior vena cava syndrome that was resected via a transcervical and full sternotomy approach. The patient was a 47-year-old male, who visited our hospital for surgical treatment of substernal goiter. The computed tomography (CT) of the neck and thorax revealed a large substernal goiter extending into the mediastinum causing tracheal compression, vessel compression, and development of collateral vessels. Total thyroidectomy was performed via a full sternotomy and transcervical approaches. Postoperatively, the patient recovered well with no nerve palsy. Histopathological examination revealed the lesion as an adenomatous goiter. Substernal goiters are usually managed by transcervical approach, but a full sternotomy is required in cases of large substernal goiter with extension up to the pericardium and the presence of superior vena cava syndrome. A multidisciplinary team approach is necessary and can help reduce the risk of complications, such as nerve injury, major vessel injury, tracheal injury, and morbidity of the surgery.
Language English
Publishing date 2022-06-10
Publishing country United States
Document type Case Reports
ZDB-ID 2747273-5
ISSN 2168-8184
ISSN 2168-8184
DOI 10.7759/cureus.25827
Database MEDical Literature Analysis and Retrieval System OnLINE

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