A case of big substernal goiter resection

Substernal goiter is considered to be a diagnostic differential for all anterosuperior mediastinal masses. For a substernal goiter, surgical removal is suggested when it is large in size, with a possibility for malignancy or has local compression of adjacent structures. This can be performed through the neck or by the addition of a partial or complete sternotomy if necessary. A 58-year-old Chinese man from Guangdong Province had had dry cough for a year. A subsequent CT scan in our hospital suggested “ectopic intrathoracic thyroid”. Fine needle percutaneous mass biopsy also suggested “ectopic intrathoracic thyroid”. We performed a standard median sternotomy to remove the mass. It measured 13 cm × 8 cm × 6 cm in size, and weighed 2.8 kg. The pathological diagnosis confirmed a benign thyroid adenoma. The patient had no hoarseness, dyspnea or hypocalcemia and was quickly extubated in the operating room. Recently, we encountered a big substernal goiter and had performed successful resection, which is reported here for reference.