Mediastinal goiter presenting with ventricular tachycardia.
BACKGROUND
We report a rare case of a mediastinal goiter confined to the thoracic inlet and cavity presenting with ventricular tachycardia as the sole clinical manifestation.


RESULTS
The patient did not have any of the typical features of a mediastinal goiter such as neck swelling, dysphagia, or respiratory difficulty, but instead had spontaneous onset of wide-complex tachycardia requiring emergency treatment. This atypical presentation led to initial misinterpretation of imaging studies and delayed diagnosis of the mediastinal mass. The large, completely intrathoracic thyroid goiter abutted the cardiac muscle and required a combined transcervical and median sternotomy approach for removal. The arrhythmia resolved postoperatively.


CONCLUSIONS
To our knowledge, this case represents the first documented presentation of ventricular tachycardia as a unique and sole feature of mediastinal goiter.
Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA.
Kevin C
KC
Gilbert
Muthuswamy
M
Dhiwakar
William S
WS
Stevens
K Thomas
KT
Robbins
D057210:Delayed Diagnosis; D006045:Goiter, Substernal / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D056346:Sternotomy; D017180:Tachycardia, Ventricular / Q000209:etiology*