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Goiter

Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...

Hyperthyroidism I: Introduction

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

Hyperthyroidism II: Pathophysiology

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...

Graves Disease II: Pathophysiology

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...

Graves' Disease I: Introduction

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence...

The Thyroid Gland

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...

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Updated: May 1, 2026

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter

Published on: September 20, 2024

Malignant presternal goitre.

T L Chow¹, Wilson W Y Kwan¹, Joyce Y H Hui²

¹Department of Surgery, United Christian Hospital, Kwun Tong, Hong Kong.

Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi

|April 10, 2014

Summary

This summary is machine-generated.

A rare presternal goitre, extending anterior to the sternum, was diagnosed as papillary thyroid carcinoma. Surgical removal of this anteriorly displaced thyroid mass requires careful consideration of surrounding muscles.

Keywords:

Carcinoma Goiter Thyroidectomy

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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.