Incidental Thyroid Goiter with Large Posterior Mediastinal Extension: A Case Report

Mediastinal goiters represent descent of thyroid tissue from the neck to the intra thoracic cavity most commonly in the anterior mediastinal compartment. Posterior mediastinal extension is uncommon, comprising only 10-15% of all mediastinal goiters. Thyroid masses within mediastinum may present with range of symptoms from being asymptomatic to severe compressive symptoms according to size and location. Surgical excision is treatment of choice in most cases. Although cervical approach is sufficient for most anterior mediastinal goiters, additional extra cervical approaches may be required for posterior mediastinal goiters. We report a case of 48-year-old female patient with an incidental finding of a thyroid goiter having large extension in right posterior mediastinum found on CT scan. It was excised using combination of cervical and Video Assisted Thoracoscopic Surgery and posterolateral thoracotomy approach with uneventful post-operative period. Histopathology revealed it to be benign multinodular goiter.