A Clinical Case of Retrosternal Goiter
Thyroid tumors arising in the mediastinum are defined as intrathoracic goiters (the terms "retrosternal" and "intrathoracic" are used interchangeably in the literature) when the mediastinal portion is larger than the cervical portion and extends beyond the thoracic inlet by two fingerbreadths or at least 4 four cm.
Patients with symptomatic retrosternal goiters are typically recommended for surgical intervention, while the treatment strategy for patients with asymptomatic retrosternal goiters remains unclear. This article describes a clinical case of preoperative risk assessment, surgical technique, and prevention of postoperative complications in a patient with a left-sided nodular goiter complicated by tracheal compression and a retrosternal location. Considering the fact that in most cases of substernal goiter the results of puncture biopsy are benign, the advisability of surgical intervention in asymptomatic patients is questionable.
Klimashevich A.V., Karpov A.A., Yudin M.Yu., Gugnin A.V. 2026. A Clinical Case of Retrosternal Goiter. Challenges in Modern Medicine, 49(2): 160–167 (in Russian). DOI: 10.52575/2687-0940-2026-49-2-160-167. EDN: SVVWIV
While nobody left any comments to this publication.
You can be first.
Список литературы
Аникин В., Велман К., Асади Н., Далал П., Решетов И., Беддоу Э. 2021. Загрудинный зоб в торакальной хирургической практике. Хирургия. Журнал им. Н.И. Пирогова. (12): 20–26. doi: 10.17116/hirurgia202112120
Battistella E., Pomba L., Sidoti G., Vignotto C., Toniato A. 2022. Retrosternal Goitre: Anatomical Aspects and Technical Notes. Medicina (Kaunas, Lithuania), 58(3), 349. https://doi.org/10.3390/medicina58030349
Can A.S., Rehman A. 2023. Goiter. In StatPearls. StatPearls Publishing.
Can A.S., Nagalli S. Substernal Goiter [Updated 2025 Jan 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557416/#
Cappellacci F., Canu G.L., Rossi L., De Palma A., Mavromati M., Kuczma P., Di Filippo G., Morelli E., Demarchi M.S., Brazzarola P., Materazzi G., Calo P.G., Medas F. and our Mediastinal Goiter Study Collaborative Group. 2024. Differences in Surgical Outcomes between Cervical Goiter and Retrosternal Goiter: An International, Multicentric Evaluation. Front. Surg. 11: 1341683. doi: 10.3389/fsurg.2024.1341683
Daggett R. L. B., Farishta D., Cuellar H., Nathan C. O. (2021). Substernal Goitre Presenting with Upper and Lower Extremity Oedema. BMJ Case Reports, 14(11), e245036. https://doi.org/10.1136/bcr-2021-245036
Landerholm K., Jarhult J. 2015. Should Asymptomatic Retrosternal Goitre be Left Untreated? A Prospective Single-Centre Study. Scandinavian Journal of Surgery. 104(2): 92–95. doi:10.1177/1457496914523411
Leivaditis V., Liolis E., Baltayiannis N., Sarof P., Pagoulatou A., Grapatsas K., Antzoulas A., Litsas D., Papadopoulos P. D., Theofanis G., Nikolakopoulos K., Katsakiori P., Papatriantafyllou A., Koletsis E., Michalaki M., Mulita F. 2025. Diving Retrosternal Goiter and the Dilemma of Sternotomy: Indications, Predictors and Surgical Considerations. Kardiochirurgia i torakochirurgia polska = Polish Journal of Cardio-Thoracic Surgery, 22(3), 174–181. https://doi.org/10.5114/kitp.2025.154929
Patel K.N., Yip L., Lubitz C.C., Grubbs E.G., Miller B.S., Shen W., Angelos P., Chen H., Doherty G.M., Fahey T.J 3rd, Kebebew E., Livolsi V.A., Perrier N.D., Sipos J.A., Sosa J.A., Steward D., Tufano R.P., McHenry C.R., Carty S.E. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults. Ann Surg. 2020 Mar; 271(3): e21–e93. doi: 10.1097/SLA.0000000000003580. PMID: 32079830
Tsur N., Levi L., Frig O., Koch N., Eshel Y., Bachar G., Shpitzer T., Yehuda M., Pescovitz Y., Wiesel O., Dudkiewicz D., Mizrachi A. (2024). Extended Cervical Approach for Retrosternal Multinodular Goiter. Acta otorhinolaryngologica Italica: organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 44(1), 21–26. https://doi.org/10.14639/0392-100X-N2746
Zuo T., Gao Z., Chen Z., Wen B., Chen B., Zhang Z. 2022. Surgical Management of 48 Patients with Retrosternal Goiter and Tracheal Stenosis: A Retrospective Clinical Study from a Single Surgical Center. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 28, e936637. https://doi.org/10.12659/MSM.936637
References
Anikin V., Welman K., Asadi N., Dalal P., Reshetov I., Beddow E. 2021. Retrosternal Goiter in Thoracic Surgical Practice. Pirogov Russian Journal of Surgery. (12): 20–26 (in Russian). https://doi.org/10.17116/hirurgia202112120
Battistella E., Pomba L., Sidoti G., Vignotto C., Toniato A. 2022. Retrosternal Goitre: Anatomical Aspects and Technical Notes. Medicina (Kaunas, Lithuania), 58(3), 349. https://doi.org/10.3390/medicina58030349
Can A.S., Rehman A. 2023. Goiter. In StatPearls. StatPearls Publishing.
Can A.S., Nagalli S. Substernal Goiter [Updated 2025 Jan 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557416/#
Cappellacci F., Canu G.L., Rossi L., De Palma A., Mavromati M., Kuczma P., Di Filippo G., Morelli E., Demarchi M.S., Brazzarola P., Materazzi G., Calo P.G., Medas F. and our Mediastinal Goiter Study Collaborative Group. 2024. Differences in Surgical Outcomes between Cervical Goiter and Retrosternal Goiter: An International, Multicentric Evaluation. Front. Surg. 11: 1341683. doi: 10.3389/fsurg.2024.1341683
Daggett R. L. B., Farishta D., Cuellar H., Nathan C. O. (2021). Substernal Goitre Presenting with Upper and Lower Extremity Oedema. BMJ Case Reports, 14(11), e245036. https://doi.org/10.1136/bcr-2021-245036
Landerholm K., Jarhult J. 2015. Should Asymptomatic Retrosternal Goitre be Left Untreated? A Prospective Single-Centre Study. Scandinavian Journal of Surgery. 104(2): 92–95. doi:10.1177/1457496914523411
Leivaditis V., Liolis E., Baltayiannis N., Sarof P., Pagoulatou A., Grapatsas K., Antzoulas A., Litsas D., Papadopoulos P. D., Theofanis G., Nikolakopoulos K., Katsakiori P., Papatriantafyllou A., Koletsis E., Michalaki M., Mulita F. 2025. Diving Retrosternal Goiter and the Dilemma of Sternotomy: Indications, Predictors and Surgical Considerations. Kardiochirurgia i torakochirurgia polska = Polish Journal of Cardio-Thoracic Surgery, 22(3), 174–181. https://doi.org/10.5114/kitp.2025.154929
Patel K.N., Yip L., Lubitz C.C., Grubbs E.G., Miller B.S., Shen W., Angelos P., Chen H., Doherty G.M., Fahey T.J 3rd, Kebebew E., Livolsi V.A., Perrier N.D., Sipos J.A., Sosa J.A., Steward D., Tufano R.P., McHenry C.R., Carty S.E. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults. Ann Surg. 2020 Mar; 271(3): e21–e93. doi: 10.1097/SLA.0000000000003580. PMID: 32079830
Tsur N., Levi L., Frig O., Koch N., Eshel Y., Bachar G., Shpitzer T., Yehuda M., Pescovitz Y., Wiesel O., Dudkiewicz D., Mizrachi A. (2024). Extended Cervical Approach for Retrosternal Multinodular Goiter. Acta otorhinolaryngologica Italica: organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 44(1), 21–26. https://doi.org/10.14639/0392-100X-N2746
Zuo T., Gao Z., Chen Z., Wen B., Chen B., Zhang Z. 2022. Surgical Management of 48 Patients with Retrosternal Goiter and Tracheal Stenosis: A Retrospective Clinical Study from a Single Surgical Center. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 28, e936637. https://doi.org/10.12659/MSM.936637