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

Area of Science:

• Thoracic Surgery
• Endocrinology
• Surgical Oncology

Background:

• Mediastinal goiters, thyroid tissue descending into the chest, most commonly occur in the anterior mediastinum.
• Posterior mediastinal goiter extension is rare, accounting for 10-15% of cases, and can cause compressive symptoms.
• Surgical excision is the primary treatment, with approach varying based on location.

Purpose of the Study:

• To report a case of a large posterior mediastinal goiter.
• To describe the surgical technique used for excision.
• To discuss the management of rare mediastinal thyroid masses.

Main Methods:

• A 48-year-old female presented with an incidentally discovered large right posterior mediastinal goiter via CT scan.
• Surgical excision was performed using a combined cervical, Video-Assisted Thoracoscopic Surgery (VATS), and posterolateral thoracotomy approach.
• Post-operative recovery was uneventful.

Main Results:

• Complete excision of the posterior mediastinal goiter was achieved.
• The patient experienced an uneventful post-operative period.
• Histopathology confirmed a benign multinodular goiter.

Conclusions:

• Combined cervical and thoracoscopic approaches are effective for excising posterior mediastinal goiters.
• This case demonstrates a successful minimally invasive strategy for a rare presentation of mediastinal goiter.
• Prompt surgical intervention is crucial for symptomatic or incidentally found mediastinal masses.