Preoperative treatment with thyroid artery embolization in a patient with a giant retrosternal goiter causing severe...

More than one-tenth of the world's population is to some degree affected by goiters. Patients with thyroid nodules usually have no symptoms, but giant retrosternal goiters often causes symptoms such as difficulty breathing due to compression. Surgical operation is currently the main treatment for giant retrosternal goiters. However, retrosternal goiters usually require open chest surgery, which carries considerable risks, increases the rate of recurrence and increases the risk of intraoperative damage to important structures such as the large blood vessels and thoracic ducts. Thyroid artery embolization has been used in the treatment of Graves' disease and as a preoperative treatment prior to thyroidectomy. In March 2025, a 70-year-old female presented to Weifang People's Hospital (Shandong, China) with a neck mass and dyspnea. A neck CT scan demonstrated an enlarged left thyroid lobe measuring 7.7x13.0 cm, extending inferiorly into the anterior mediastinum and causing tracheal compression that resulted in rightward displacement and flattening of the trachea. The patient presented with dyspnoea at rest. Given the notable size of the mass, thyroid artery embolization was performed, followed by left thyroidectomy. The surgery was conducted without complications such as hoarseness or hypocalcemia and did not necessitate a thoracotomy. Thyroid artery embolization alleviated the tracheal compression symptoms of the patient, restored oxygen saturation to normal levels and rendered the patient suitable for general anesthesia. The mass was successfully removed through cervical surgery alone, thereby avoiding thoracotomy and minimizing iatrogenic trauma during treatment.