title: Retrosternal goiter located in the mediastinum: surgical approach and operative difficulties.
abstract: Most retrosternal goiters are situated in the anterior mediastinal compartment, but according to the literature, 10-15% are located in the posterior mediastinum. Although most of the anterior mediastinal goiters can be removed by a transcervical approach, posterior mediastinal goiters may require additional extracervical incisions. We report the case of a huge posterior mediastinal goiter extending from the neck retrotracheally beyond the aortic arch and azygous vein with crossover from the left to the right side and ending at the level of the lower part of the left cardiac atrium, nearly reaching the diaphragm. Surgical removal is the treatment of choice in such cases. We performed an operation using a transcervical and right thoracotomy approach. Histopathological examination confirmed the diagnosis of the large goiter. The patient recovered well and was discharged in 1 week.
authors.affiliation: Wroclaw Thoracic Surgery Centre, Lower Silesian Centre of Lung Diseases, Medical University, Wroclaw, Poland. grzegorzkacprzak@interia.pl
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Kacprzak
authors.forename: Jacek
authors.initials: J
authors.lastname: Karas
authors.forename: Adam
authors.initials: A
authors.lastname: Rzechonek
authors.forename: Piotr
authors.initials: P
authors.lastname: Blasiak
mesh_terms: D005260:Female; D006045:Goiter, Substernal / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D013908:Thoracotomy; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome