When asthma medication fails: a large retrosternal goiter as the underlying cause of airway obstruction

Goiter is a common benign condition that typically presents with a sensation of pressure in the neck. In a slowly growing disease, the pressure symptom may be confused with another disease causing airway obstruction, and the diagnosis becomes even more difficult if the enlarged thyroid gland is located behind the sternum and not just in the neck. We describe a case of a patient who suffered from treatment-resistant obstructive airway symptoms for years, experienced several upper and lower respiratory tract infections, and underwent repeated investigations for asthma. Eventually, a large retrosternal goiter was identified as the cause of the symptoms, which was treated surgically.