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Abstract: Background: We describe the clinical characteristics of patients with mediastinal goiter and our principles in surgical management of this pathology; we also identify the predictive factors of malignancy, sternotomy, and posterior mediastinal extension. Methods: We conducted a retrospective chart review of 60 patients with mediastinal goiter who underwent surgical intervention. Results: Major perioperative complications were recurrent laryngeal nerve sacrifice (3.3%) and vagus nerve sacrifice (1.7%). A total of 12.7% of cases were malignant. The presence of dysphonia increased the likelihood of malignancy (P = .02), and malignancy was associated with a significant increase in sternotomy (P = .04) and nerve sacrifice (P < .001) during surgery. A history of thyroidectomy was a predictive factor for extension of the tumor to the posterior mediastinum (P = .02). Conclusions: Presenting with dysphonia is a predictor of malignancy that necessitates careful surgical planning because malignancy is associated with an increase in nerve injury and sternotomy during surgery. [Copyright &y& Elsevier]

Background: Disparities distinguishing patients with substernal goiters from nonsubsternal goiters have not been thoroughly described., Methods: The National Inpatient Sample database was used to compare patients who underwent substernal thyroidectomy years 2000 to 2010 with those who underwent thyroidectomy for nonsubsternal goiter., Results: A total of 110,889 patients underwent thyroidectomy for goiter (5,525 substernal and 105,364 nonsubsternal). Substernal thyroidectomy patients were older, more likely to be Black or Hispanic and to have Medicare insurance. They had a higher comorbidity index, were more likely to be admitted emergently and to have postoperative complications such as hemorrhage/hematoma, pneumothorax, pulmonary embolism, and hypocalcemia/hypoparathyroidism. Furthermore, substernal thyroidectomy patients had 73% increased odds of death during admission than nonsubsternal thyroidectomy patients., Conclusions: Substernal goiters present a distinct type of goiter with identifiable patient-level characteristics and an increased risk of postoperative complications and death. Earlier identification and treatment of goiters may allow earlier interventions at a stage when risks are reduced., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Abstract: Solitary fibrous tumor is an uncommon neoplasm. We present a case of solitary fibrous tumor of the perithyroidal soft tissue mimicking a substernal goiter. [Copyright &y& Elsevier]