Malignant presternal goitre.

Area of Science:

• Endocrinology
• Surgical Oncology
• Anatomic Pathology

Background:

• Goitres typically enlarge and descend into the substernal space.
• Presternal goitres, extending anterior to the sternum, represent an unusual anatomical presentation.
• Understanding the developmental mechanism of presternal goitres is crucial for diagnosis and treatment.

Observation:

• A patient presented with a thyroid mass that had descended anterior to the sternum.
• The unusual location of the goitre made it non-palpable in the typical substernal region.
• Diagnostic imaging and subsequent surgical exploration were necessary to characterize the mass.

Findings:

• The thyroid mass was successfully removed via surgical extirpation.
• Histopathological examination confirmed the presence of papillary thyroid carcinoma within the goitre.
• The mechanism likely involved invasion and erosion of the strap muscles and cervical linea alba.

Implications:

• Presternal goitres necessitate a tailored surgical approach for complete removal.
• Complete extirpation should include a margin of the adjacent strap muscles.
• This case highlights the importance of considering atypical anatomical presentations in thyroid pathology.