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Updated: Feb 18, 2026
Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
Trans-cervical resection of a separate substernal goitre
Henry To1, Antara Karmakar1, Stephen Farrell2
1Department of Surgery, The Northern Hospital, 185 Cooper St, Epping, Victoria, 3076, Australia.
Introduction:
A separate substernal goitre which is not continuous with the main cervical thyroid proves a unique challenge for resection. A trans-cervical approach is preferred but may be hazardous due to the possibility of ectopic thyroid tissue with alternate blood supply.
Presentation Of Case:
A 72year old female who had a previous left hemithyroidectomy presents with a symptomatic central substernal thyroid mass. Following radiological work-up, the separate goitre was carefully removed via a trans-cervical approach and avoidance of sternotomy. She had a rapid recovery without complication.
Discussion:
The anatomy and embryology of substernal masses need to be carefully considered particularly if the mass is ectopic thyroid tissue. Careful pre-operative assessment may determine its nature and anatomical features. Intra-operative dissection requires consideration of blood supply and surrounding structures, but often may be and is best completed via a cervical approach to minimise morbidity. Review of the literature affirms the preference for a trans-cervical approach and offers criteria for successful resection via this method.
Conclusion:
Confirming the nature and anatomy of a separate substernal goitre enables successful removal of the mass via a trans-cervical approach with minimal morbidity.
