Mediastinal goiter presenting with ventricular tachycardia.

Area of Science:

• Cardiology
• Endocrinology
• Thoracic Surgery

Background:

• Mediastinal goiters are typically associated with compressive symptoms like dysphagia or respiratory distress.
• This case presents a rare instance of a mediastinal goiter without these characteristic signs.

Observation:

• A patient experienced spontaneous ventricular tachycardia as the sole manifestation of a mediastinal goiter.
• The intrathoracic thyroid mass abutted cardiac muscle, complicating diagnosis and surgical approach.

Findings:

• The atypical presentation led to initial misinterpretation of imaging studies and delayed diagnosis.
• Surgical removal via a combined transcervical and median sternotomy approach was successfully performed.
• Postoperative resolution of ventricular tachycardia confirmed the goiter as the cause of the arrhythmia.

Implications:

• This case underscores the importance of considering unusual etiologies for cardiac arrhythmias.
• Highlights the need for comprehensive diagnostic evaluation in atypical presentations of mediastinal masses.
• Suggests that mediastinal goiters can present solely with cardiac manifestations, challenging typical diagnostic paradigms.