[Retrosternal goitres. Study of a series of 34 cases (author's transl)]

On the basis of study of 34 records of patients operated upon for retrosternal goitre, the authors attempt to assess the diagnostic approach and methods of treatment. Relatively rare (6% in our total group of patients undergoing thyroidectomy for cervical goitres), and particularly frequent amongst the elderly woman, retrosternal goitres often present as the result of a complication. The diagnosis is usually easy on the basis of standard chest X-rays. Other than in special cases, more complicated investigations are usually of no use. Isotope scan of the thyroid rarely gives valuable information concerning the retrosternal nature of the goitre. The retrosternal portion usually shows no uptake. The risk of malignant change is as high as for cervical goitres. Carcinoma sometimes presents as a metastasis. The treatment of a retrosternal goitre is usually simple, as long as the correct plane of cleavage is found at the outset. Surgical excision by simple cervicotomy is standard, even when the tumour is large in size. Finally, the authors emphasise the value of surgery earlier and more often, even in the absence of complications.