Neglected Retrosternal Goitre: A management Dilemma

Abstract

Mediastinal goiters were first described by Albrecht von Haller in 1749, as the extension of the thyroid tissue below the upper opening of the chest.1 As goiters grow they attain a mediastinal position by extending through the thoracic inlet. As these mediastinal goiters grow very slowly and are present over many years, they often go unrecognized either because the thyroid mass is managed conservatively by suppressive therapy or the compressive symptoms misinterpreted as cardiopulmonary symptoms, leading to the late diagnosis or even misdiagnosis. Here lies the importance of taking a detailed history, carrying out a thorough clinical and investigative evaluation and maintaining an open mind. Advancing age is associated with increased medical co-morbidity, implying that operation at an earlier stage of goitre development may be associated with reduced complications related to co-existing disease. Here, we report an interesting case of 37 year old female with neglected retrosternal goitre.