Forgotten Goiter Presenting As Acute Respiratory Distress Following a Thyroidectomy: A Case Report

Airway complications account for a significant amount of post-thyroidectomy complications. Forgotten goiter is a residual thyroid mass left after total thyroidectomy, an event already depicted in the literature. Clinical presentation is diverse, ranging from asymptomatic tracheal deviation to symptoms caused by hormonally active thyroid tissue or airway obstruction due to mass effect. However, it has never been documented as the cause of acute respiratory distress following thyroid surgery. We report the case of a 65-year-old female undergoing left hemithyroidectomy due to long-standing substernal goiter. Anesthesia induction and surgery were uneventful. On extubation, the patient presented with acute respiratory distress requiring prompt airway management. A computed tomography scan revealed residual intrathoracic goiter resulting in significant airway compression. Therefore, although a rare event, a forgotten goiter should be considered by a multidisciplinary team when patients undergoing surgery for substernal goiter develop acute postoperative airway obstruction after common post-thyroidectomy complications have been excluded.