Surgical treatment of substernal goiter.
BACKGROUND
Substernal goiter differs from its cervical counterpart in regard to its clinical presentation, surgical management, pathological analysis and postoperative complication.


METHODS
Retrospective analysis of 1320 thyroidectomies performed at the Hacettepe University Hospital between 1990 and 1997.


RESULTS
30 (2.3%) of 1320 thyroidectomies underwent operation for removal of substernal goiters in an 8-year period. The most common symptom was cervical mass (67%) and 33% of the patients were asymptomatic. Computerised tomography was the most accurate pre-operative test for detecting substernal extension. Substernal goiters were removed by collar incisions in 93% of the cases. The pathology was generally found to be benign (94%), but follicular carcinoma was present in two (6%) patients. There was no mortality and no complications were observed in 73% of the patients.


CONCLUSIONS
The presence of substernal goiter is an indication for removal given the lack of any effective medical therapy, low surgical morbidity, risk of malignancy and acute obstructing symptoms.
Ozdemir
A
A
Department of Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Hasbahceci
M
M
Hamaloglu
E
E
Ozenc
A
A
D000328:Adult; D000368:Aged; D005260:Female; D006045:Goiter, Substernal / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged