open access
Successful combined surgical approach in a rare case of retrotracheal goitre in a patient with anatomical impediments
open access
Abstract
Diving goitres can descend the cervical region expanding directly into the thoracic cavity. In most cases, diving goitres extend into the anterosuperior compartment, but they may also extend behind the trachea. We herein present a case of a male patient with retrotracheal goitre and history of left thyroid lobectomy and median sternotomy for thoracic aortic aneurysm repair with graft placement. After detailed preoperative evaluation, the patient underwent surgical resection of the mass through a combined approach; the existing cervical incision and a right posterolateral mini-thoracotomy. The postoperative course of the patient was uncomplicated. One year after surgery, the patient is asymptomatic and disease-free. (Folia Morphol 2018; 77, 1: 166–169)
Abstract
Diving goitres can descend the cervical region expanding directly into the thoracic cavity. In most cases, diving goitres extend into the anterosuperior compartment, but they may also extend behind the trachea. We herein present a case of a male patient with retrotracheal goitre and history of left thyroid lobectomy and median sternotomy for thoracic aortic aneurysm repair with graft placement. After detailed preoperative evaluation, the patient underwent surgical resection of the mass through a combined approach; the existing cervical incision and a right posterolateral mini-thoracotomy. The postoperative course of the patient was uncomplicated. One year after surgery, the patient is asymptomatic and disease-free. (Folia Morphol 2018; 77, 1: 166–169)
Keywords
retrotracheal, goitre, aortic grafting, thyroidectomy, thoracotomy
Title
Successful combined surgical approach in a rare case of retrotracheal goitre in a patient with anatomical impediments
Journal
Issue
Article type
Case report
Pages
166-169
Published online
2017-08-18
Page views
1921
Article views/downloads
1144
DOI
Pubmed
Bibliographic record
Folia Morphol 2018;77(1):166-169.
Keywords
retrotracheal
goitre
aortic grafting
thyroidectomy
thoracotomy
Authors
E. Spartalis
C. Damaskos
D. Moris
A. Athanasiou
M. Spartalis
G. Karagkiouzis
D. Schizas
D. Dimitroulis
P. Tomos
- Burns P, Doody J, Timon C. Sternotomy for substernal goitre: an otolaryngologist's perspective. J Laryngol Otol. 2008; 122(5): 495–499.
- Chong CF, Cheah WK, Sin FL, et al. Posterior mediastinal goiter. Asian Cardiovasc Thorac Ann. 2004; 12(3): 263–265.
- Cohen J, Cho H. Surgery for substernal goiters. Oper Techn Otolaryngol Head Neck Surg. 1994; 5(2): 118–125.
- Cohen J. Substernal goiters and sternotomy. Laryngoscope. 2009; 119(4): 683–688.
- Cougard P, Matet P, Goudet P, et al. Les goitres plongeants: 218 cas operes. Ann Endocrinol (Paris). 1992; 53: 230–235.
- Dahan M, Gaillard J, Eschapasse H. Surgical treatment of goiters with intrathoracic development. In: Delarue M (ed) International trends in general thoracic surgery. Thoracic Surgery: Frontiers and uncommon neoplasms. Mosby, St Louis, Volume 5. 1989; 240: 246.
- de Perrot M, Fadel E, Mercier O, et al. Surgical management of mediastinal goiters: when is a sternotomy required? Thorac Cardiovasc Surg. 2007; 55(1): 39–43.
- De Souza FM, Smith PE. Retrosternal goiter. J Otolaryngol. 1983; 12: 393–396.
- Flati G, De Giacomo T, Porowska B, et al. Surgical management of substernal goitres. When is sternotomy inevitable? Clin Ter. 2005; 156(5): 191–195.
- Hashmi SM, Premachandra DJ, Bennett AMD, et al. Management of retrosternal goitres: results of early surgical intervention to prevent airway morbidity, and a review of the English literature. J Laryngol Otol. 2006; 120(8): 644–649.
- Huins CT, Georgalas C, Mehrzad H, et al. A new classification system for retrosternal goitre based on a systematic review of its complications and management. Int J Surg. 2008; 6(1): 71–76.
- Monchik JM, Materazzi G. The necessity for a thoracic approach in thyroid surgery. Arch Surg. 2000; 135(4): 467–71; discussion 471.
- Sancho JJ, Kraimps JL, Sanchez-Blanco JM, et al. Increased mortality and morbidity associated with thyroidectomy for intrathoracic goiters reaching the carina tracheae. Arch Surg. 2006; 141(1): 82–85.
- Shahian DM, Rossi RL. Posterior mediastinal goiter. Chest. 1988; 94(3): 599–602.
- Spartalis ED, Karatzas T, Charalampoudis P, et al. Neglected papillary thyroid carcinoma seven years after initial diagnosis. Case Rep Oncol Med. 2013; 2013: 148973.
- Vadasz P, Kotsis L. Surgical aspects of 175 mediastinal goiters. Eur J Cardiothorac Surg. 1998; 14(4): 393–397.
- White ML, Doherty GM, Gauger PG. Evidence-based surgical management of substernal goiter. World J Surg. 2008; 32(7): 1285–1300.