[Diagnosis and treatment of substernal and mediastinal goiter]

Clinical picture, methods of diagnosis and treatment of 42 patients with retrosternal (23), "diving" (6), and mediastinal (13) strumas were studied. A conclusion was drawn that these goiters had no specific signs. In the absence of thyrotoxicosis the clinical picture is conditioned by the compression and displacement of the mediastinal organs, and in its presence symptoms characteristic of thyrotoxic goiter are added. The most important method of diagnosis of retrosternal and mediastinal goiters in considered to be polypositional roentgenotomography, pneumomediastinography, contrast examination of the esophagus, trachea, vessels, and, in a number of patients, radioiodinediagnosis. Surgical treatment of retrosternal and mediastinal goiters is recommended.