CT scan of substernal goiter. Case illustrating the characteristic appearance of a large goiter with an intrathoracic extension (substernal goiter). Szuba A(1), Poreba R, Podgórski F, Andrzejak R. Author information: (1)Department of Internal Medicine, Wroclaw Medical University, Wroclaw, Poland. A chronic compression of the upper mediastinal veins by a retrosternal goiter. VID 1050, frame 4. thyT4111 : CT scan of substernal goiter (highlighted). Ninety patients had substernal goiters. References 1. 1,2 Although the overall incidence of goiter in the United States has decreased during the last century with the widespread use of iodine supplementation, large goiters are still commonly encountered; substernal goiters are documented in 3% to 20% of all operations for goiter. The word goiter is derived from “guttur,” the Latin term for throat. To see: 2 cases, 11 pictures. Contrast-enhanced CT of the chest shows a large, contrast-enhancing mass in the anterior mediastinum containing calcifications and areas of necrosis. Histology reveals multinodular goiter, follicular adenoma, Hashimoto’s thyroiditis or occult papillary carcinoma. in misleading substernal localization of the goiter. It can press on pathways to your lungs or stomach and cause problems. Retrosternal (Substernal) Goitre Presentation. Solitary fibrous tumor of the perithyroidal soft tissue mimicking substernal goiter. CT scan showing goiter displacing mediastinal structures. When this occurs, thyroidectomy surgery (excision of part or all of the thyroid gland) has unique considerations that are important to understand for the surgeon and patient. Fig.1: Chest XRay of retrosternal goitre showing marked deviation of the trachea (windpipe) to left A retrosternal or substernal goitre occurs when the thyroid grows downwards from the neck into the chest. There are multiple causes of goiters and their presence does not necessarily indicate that the thyroid gland is malfunctioning on a hormonal level. Enlarged thyroid glands (ie, goiters) often extend in the mediastinum posterior to the sternum, making the gland, by definition, a substernal (or retrosternal) goiter. Try … Posterior Mediastinal Goiters (Substernal Goiter Type II) Most surgical and radiographic series suggest that substernal goiters affect the anterior mediastinum in approximately 85% of patients and the posterior mediastinum in approximately 15% (see Table 7-1). These two studies look at how substernal goiters impact surgical outcome and how to predict who may need a procedure that requires opening the chest. Case illustrating the characteristic appearance of a large goiter with an intrathoracic extension (substernal goiter). A goiter is a thyroid gland that has grown larger than it should. Introduction: Goiter is localized or generalized thyroid hypertrophy. Such goiters are called substernal, although retrosternal is probably a more precise term. Large Benign Goiters: Special Considerations for Management. Haller was the first to describe substernal goiter in 1749 as the extension of thyroid tissue below the upper opening of the chest 1,2.Today, substernal goiter is characterized when more than 50% of the gland is extended into the chest, thus requiring dissection of the upper mediastinum. This report is about a large substernal goiter, which was resected via a transcervical and full sternotomy approach. Substernal goiter can be classified as primary or secondary, depending on the site of origin. VID 1050, frame 3. thyT4109 : CT scan of substernal goiter (highlighted). Figure 2. Substernal type of retrosternal goiter can be felt as a palpable nodule in the lower neck.
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