Posterior Mediastinal Goiter Removal Through Cervical Incision

Area of Science:

• Endocrinology
• Thoracic Surgery
• Neurosurgery

Background:

• Intrathoracic goiters can present diagnostic and surgical challenges.
• Surgical approaches typically involve cervical incisions, but extensive substernal extension may necessitate additional thoracic approaches.
• Pituitary macroadenoma can be associated with secondary thyroid enlargement.

Purpose of the Study:

• To report a case of a large intrathoracic goiter with posterior mediastinal extension managed successfully via a cervical collar incision.
• To highlight the feasibility of a minimally invasive approach in complex goiter cases.
• To emphasize the importance of case-by-case decision-making for surgical approach selection.

Main Methods:

• A cervical collar incision was utilized for thyroidectomy.
• A vessel sealing device was employed for hemostasis.
• The adenomatous goiter extending into the posterior mediastinum was completely removed.
• The patient had a concurrent diagnosis of pituitary macroadenoma.

Main Results:

• Complete resection of the intrathoracic goiter was achieved through the cervical incision.
• No intraoperative or postoperative complications were observed.
• The patient experienced an uneventful recovery.

Conclusions:

• Thyroidectomy for intrathoracic goiter with posterior mediastinal extension is feasible via a cervical incision.
• Minimally invasive techniques, such as using a vessel sealing device, can enhance safety and efficacy.
• Avoiding sternotomy or thoracotomy reduces surgical morbidity, underscoring the need for individualized surgical planning.