[Cervico-mediastinal goitre. Analysis of preoperative clinical symptoms]

During past decades, a considerable and debated speculation about the classification of intrathoracic goitre was more and more developing. One of the most reliable classifications we share is that considering the degree of the intrathoracic extension of the thyroid gland: i) largely intrathoracic (more than 80%), ii) partially intrathoracic (more than 50%, but less than 80%), and iii) sub-sternal goitre (more than 50% holding in the neck). Consistently with the above mentioned classification, this report deals with ninety-seven cases of completely intrathoracic goitre (64 females and 33 males, aging between 29 and 78 years). Sixty-eight patients out of these showed a goitre reaching the upper aortic border; the other 29 patients had a thyroid gland exceeding this degree of extension. Therefore the intrathoracic goitre is a not frequent thyroid disease: in our series, it represents the 3.67% of 2641 surgical interventions on the thyroid gland from January 1984 to December 1990, that is to say the 20% of the so-called plongeant goitres undergoing surgery during the same years. The aim of this survey was to study the clinical features of the intrathoracic goitre and to have a therapeutic and prognostic assessment in this thyroid disease, before the surgical intervention. To this purpose, the prodromic symptom or sign, the clinical course before surgery, the clinical examination (peculiarly about the neck) and the laboratory findings at admission, the preoperative imaging study (chest X-ray, ultrasound examination, scintiscan and tomoscan finding) were reviewed.(ABSTRACT TRUNCATED AT 250 WORDS)