Isolated Mediastinal Goitre: A Case Report.

Area of Science:

• Endocrinology
• Surgical Oncology
• Radiology

Background:

• Retrosternal goiters are relatively common, often resulting from factors like delayed diagnosis, fear of surgery, or incomplete thyroidectomies.
• Presentation can be atypical, particularly in patients with a history of thyroid surgery.

Purpose of the Study:

• To report a rare case of isolated mediastinal goiter (Type 3) in a patient with a history of thyroid surgery.
• To emphasize the importance of computed tomography (CT) imaging and grading in diagnosing and planning treatment for retrosternal goiters.
• To discuss the surgical approach for managing mediastinal goiter with potential cervical and mediastinal components.

Main Methods:

• A 53-year-old female with a history of thyroid surgery presented with a large neck swelling.
• Computed tomography (CT) imaging revealed an isolated mediastinal goiter (Type 3) without connection to the cervical thyroid.
• The patient underwent total thyroidectomy and mediastinal goiter excision using a combined cervical and median sternotomy approach.

Main Results:

• Postoperative histopathology confirmed a benign adenomatous goiter.
• CT imaging was crucial for identifying the extent and type of the retrosternal goiter.
• The surgical intervention via cervical and sternotomy approach was successful in excising the mediastinal goiter.

Conclusions:

• CT imaging and appropriate grading are essential for evaluating retrosternal goiters.
• Mediastinal extension or seeding of thyroid goiter can occur, especially after previous thyroid surgery.
• Extra-cervical surgical approaches, such as sternotomy, are recommended for managing primary mediastinal goiters.