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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
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Related Experiment Video

Updated: Oct 14, 2025

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
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Substernal goitre presenting with upper and lower extremity oedema.

Rebekah LeAnn Bennett Daggett1, Daniel Farishta2, Hugo Cuellar3

  • 1School of Medicine, LSUHSC-S, Shreveport, Louisiana, USA.

BMJ Case Reports
|November 2, 2021
PubMed
Summary

A rare substernal goitre case presented with severe lower extremity (LE) lymphoedema. Surgical removal resolved the lymphoedema and improved mobility, highlighting an unusual clinical association.

Keywords:
cardiothoracic surgeryotolaryngology / ENTthyroid disease

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Area of Science:

  • Endocrinology
  • Vascular Surgery
  • Thoracic Surgery

Background:

  • Substernal goitres typically cause compressive airway and esophageal symptoms.
  • Surgical intervention is common for chronic, progressive goitre-related symptoms.

Observation:

  • A rare case of substernal goitre in an elderly male presented with severe bilateral lower extremity (LE) lymphoedema and unilateral upper extremity lymphoedema.
  • Initial investigations for filariasis were negative, despite prior travel history.
  • A chest CT scan incidentally revealed a substernal goitre compressing adjacent structures.

Findings:

  • Surgical excision of the substernal goitre (left hemithyroidectomy via cervical excision and sternotomy) was performed.
  • The patient experienced an uneventful recovery.
  • Post-operatively, the patient's lymphoedema resolved, and mobility was restored.

Implications:

  • This case highlights severe lower extremity lymphoedema as a rare, previously under-recognized clinical presentation of substernal goitre.
  • It underscores the importance of comprehensive imaging in diagnosing atypical goitre presentations.
  • Early surgical management can lead to significant improvement in quality of life for patients with such rare associations.