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Retrotracheal goiter: a diagnostic and therapeutic problem
D Waldron1, J Coffey, S Murphy
1Department of Thoracic Surgery, St. Vincent's Hospital, Dublin, Ireland.
The Annals of Thoracic Surgery
|July 1, 1990
Summary
A retrotracheal mass causing chronic cough and dysphagia was diagnosed as a thyroid adenoma. Surgical excision via thoracotomy proved effective for this unusual mediastinal thyroid lesion.
Area of Science:
- Thoracic surgery
- Endocrinology
- Diagnostic imaging
Background:
- Mediastinal masses can present with diverse symptoms, including chronic cough and dysphagia.
- Retrotracheal lesions pose diagnostic challenges, often requiring advanced imaging and biopsy.
- Thyroid tissue in the mediastinum is uncommon but can lead to significant clinical issues.
Observation:
- Chest roentgenogram revealed a retrotracheal mass extending into the visceral mediastinum.
- Computed tomographic scan confirmed the retrotracheal lesion, initially suspected to be lymphatic.
- Thyroid scan showed inferior displacement of the left thyroid lobe with minimal uptake in the mass.
Findings:
- Histological examination of mediastinal biopsies yielded inconclusive results.
- The retrotracheal mass was definitively diagnosed as a large thyroid adenoma.
- Successful excision of the thyroid adenoma was achieved through a right thoracotomy approach.
Implications:
- This case highlights the importance of considering ectopic thyroid tissue in the differential diagnosis of mediastinal masses.
- Right thoracotomy is a safe and effective surgical approach for accessing and excising retrotracheal thyroid adenomas.
- Diagnostic strategies for unusual mediastinal lesions may require a multidisciplinary approach combining imaging and surgical exploration.