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Diagnosis and surgical management for retrosternal thyroid mass
Yushang Cui1, Zhiyong Zhang, Shanqing Li
1Department of Thoracic Surgery, PUMC Hospital, CAMS & PUMC, Beijing 100730.
Objective:
To understand the clinical manifestations, diagnostic methods, surgical management and prognosis of retrosternal thyroid masses in various pathological types.
Methods:
Sixty-four cases of retrosternal thyroid masses with surgical intervention were analyzed retrospectively.
Results:
Trachea-compressed symptoms (65%) and shadows beside the trachea at thoracic inlet (94%) were the most common clinical findings, chest X-ray (70%) and CT scan (96%) had higher diagnostic rate. No death occurred during operation or hospitalization among these patients. Total complications occurred in 15.7% cases (11/70) (including 3 preoperative cases with hoarseness) and postoperative pathological results were mainly multinodular goiter (54.7%), thyroid adenoma (21.9%) and thyroid carcinoma (15.6%) (including local carcinomatous change).
Conclusions:
Diagnosis of retrosternal thyroid mass can be correctly made by chest X-ray and CT scan. Most operations on retrosternal thyroid masses can be performed safely through cervical incision with minimal morbidity and low recurrence rate. Retrosternal thyroid carcinoma was potentially invasive and could hardly be resected completely, hence with poor prognosis.