Cervico-mediastinal thyroid masses - our experience

Area of Science:

• Thoracic Surgery
• Endocrinology
• Surgical Oncology

Background:

• Cervico-mediastinal goiters and thyroid masses have diverse definitions and classifications.
• A 22-year retrospective analysis of clinical presentation, diagnostics, and surgical outcomes for these masses was conducted.

Purpose of the Study:

• To analyze clinical presentation, diagnostic procedures, and surgical techniques for cervico-mediastinal thyroid masses.
• To evaluate post-operative complications and results in relation to surgical approaches.

Main Methods:

• A review of 130 patients (77 female, 53 male; mean age 53) who underwent surgery for retrosternal thyroid masses between 1991 and 2012.
• Cervico-thoracic CT scans were used for diagnosis and assessment of intrathoracic progression and tracheal compression.
• Surgical approaches included cervical incision (106 cases), cervicotomy with partial upper sternotomy (20 cases), full sternotomy (3 cases), and axillary thoracotomy (1 case).

Main Results:

• All 130 patients achieved successful removal of the thyroid mass and tracheal decompression.
• Post-operative outcomes were highly satisfactory, with no respiratory distress and normal vocal cord function.
• No post-operative mortality was recorded.

Conclusions:

• Surgical excision is the definitive treatment for cervico-mediastinal thyroid masses, regardless of respiratory distress.
• Cervical incision is effective for excising these masses, and bipolar approaches offer excellent outcomes for large, complex cases.
• The study highlights the importance of tailored surgical techniques for safe and successful resection.