PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Goiter, Substernal”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMed1995

Retrosternal goiter.

BACKGROUND: Retrosternal goiter is a common cause of compression of adjacent structures, and it may harbor cancer. METHODS: During a 22-year period, we treated 44 patients with intrathoracic multinodular goiter. RESULTS: The goiter was resected in 40 patients; 4 patients were rejected because of prohibitive risk. There were three minor complications and no deaths. CONCLUSIONS: The specific indications for resection include compression of adjacent structures, prevention of future complications, and obtaining a diagnosis. Fine-needle aspiration for diagnosis is not always possible and rarely reliable, and there is no effective medical therapy. Cervical incision is nearly always adequate, with few exceptions, such as very large posterior goiter, mediastinal blood supply, or carcinoma necessitating mediastinal dissection.

Aged↗
PubMed1997

Primary mediastinal tumors. Part 1: tumors of the anterior mediastinum.

Primary anterior mediastinal neoplasms comprise a diverse group of tumors and account for 50% of all mediastinal masses. Thymomas are most common and can be locally invasive and associated with parathymic syndromes. Thymic carcinomas and thymic carcinoids are rare malignancies with a propensity for local invasion and distant metastases. Thymolipomas are benign thymic tumors. The mediastinal germ cell tumors are a heterogeneous group of benign and malignant neoplasms. Mediastinal lymphangiomas are rare tumors and predominantly occur in young children. In contrast, mediastinal goiters are relatively common in adults. Mediastinal parathyroid adenomas are an uncommon cause of persistent hyperparathyroidism and rarely cause a discernible mass. The clinical, radiologic, and therapeutic aspects of the most common masses are reviewed.

Adenoma↗
PubMed2003

Orthopnea and tidal expiratory flow limitation in patients with euthyroid goiter.

BACKGROUND: Nontoxic goiters can cause extrathoracic upper airway obstruction and, if large, may extend into the thorax, causing intrathoracic airway obstruction. Although patients with goiter often report orthopnea, there are few studies on postural changes in respiratory function in these subjects. PURPOSE: The aim of this study was to investigate the postural changes in respiratory function and the presence of flow limitation (FL) and orthopnea in patients with nontoxic goiter. METHODS: In 32 patients with nontoxic goiter, respiratory function was studied in seated and supine position. Expiratory FL was assessed with the negative expiratory pressure method. Goiter-trachea radiologic relationships were arbitrarily classified as follows: grade 1, no evidence of tracheal deviation; grade 2, tracheal deviation present in lateral and/or anteroposterior plane but with tracheal compression < 20%; and grade 3, tracheal deviation present with compression > 20%. Subgroups were considered according to this classification and occurrence of orthopnea and FL. RESULTS: In all three groups of patients, the average maximal expiratory flow at 50% of FVC/maximal inspiratory flow at 50% of FVC ratios were > 1.1, suggesting the presence of upper airway obstruction. Grade 3 patients had a significantly lower expiratory reserve volume and maximal expiratory flow at 25% of FVC and higher airway resistance and 3-point FL score than patients with grade 1 and grade 2. The prevalence of orthopnea was highest in patients with grade 3 (75%, as compared to 18% in the grade 1 group). In patients with orthopnea, the prevalence of intrathoracic goiter was also higher (78%, vs 21% in patients without orthopnea). CONCLUSION: There is a high prevalence of orthopnea in patients with goiter, especially when the location is intrathoracic and causes a reduction of end-expiratory lung volume and flow reserve in the tidal volume range, promoting FL especially in supine position. Obesity is a factor that increases the risk of orthopnea in patients with goiter.

Cross-Sectional Studies↗
PubMed1975

Benign superior vena cava syndrome.

Benign superior vena cava (SVC) obstruction is an uncommon entity. However, it is important to recognize that a small percentage of SVC syndromes are due to benign diseases such as mediastinal granulomas. The insidious onset and slow progression of symptoms allow for development of an efficient collateral venous circulation compatible with long-term survival. Surgical intervention to bypass the obstruction is often unsuccessful and should be avoided in most cases. We review the English literature on the subject, classify the various causes of benign SVC syndrome, and report our experience with 16 documented cases.

Adult↗
PubMed1990

Management of a large mediastinal cyst of thyroid origin.

Large mediastinal cysts of the thyroid are rare and it is difficult to make a definitive tissue diagnosis prior to surgical removal. Ultrasonography and computed axial tomography are useful in documenting the cystic nature of the lesion and demonstrating its relationship to other mediastinal structures. These studies may also suggest the tissue of origin. We report a case of massive mediastinal thyroid cyst situated in the right posterior mediastinum and causing significant tracheal compression. Because of this unusual location and lack of iodine uptake, preoperative diagnosis was not possible. At surgery, which we performed via right thoracotomy because of the location of the mass, its origin from thyroid tissue was demonstrated. Resection was accomplished with care taken not to injure the recurrent laryngeal nerve. The patient recovered uneventfully.

Diagnostic Imaging↗
PubMed1996

Pituitary apoplexy after subtotal thyroidectomy in an acromegalic patient with a large goiter.

A case of pituitary apoplexy occurring after subtotal thyroidectomy in an acromegalic woman with a large adenomatous goiter is described. The patient had severe apnea because the large goiter was causing airway compression. Prior to the planned hypophysectomy, a subtotal thyroidectomy was performed to relieve tracheal stenosis. Shortly after the operation, the patient developed a headache that lasted for several days. The serum levels of growth hormone and somatomedin-C spontaneously normalized seventeen days after this episode and have remained normal for two years. Pituitary apoplexy was thought to have caused the observed results without deterioration of the pituitary function.

Acromegaly↗
PubMed1983

Computed tomography of intrathoracic goiters.

Ten patients with intrathoracic goiters were evaluated by computed tomography (CT). In comparison with chest radiographs, CT showed additional features helpful in suggesting the correct diagnosis. These observations included: (1) clear continuity with the cervical thyroid gland (8/10 cases); (2) well defined borders (9/10); (3) punctate, coarse, or ringlike calcifications (8/10); (4) nonhomogeneity (9/10) often with discrete, nonenhancing, low-density areas (6/10); (5) precontrast attenuation values at least 15 H greater than adjacent muscles (4/10) with more than 25 H after contrast enhancement (8/8); and (6) characteristic patterns of goiter extension into mediastinum.

Adult↗
PubMed1987

Efficacy of thyroid scintigraphy in the diagnosis of intrathoracic goiter.

For evaluation of the usefulness of thyroid scintigraphy in the diagnosis of intrathoracic goiter, we analyzed the results of radionuclide thyroid scintigraphy in 54 consecutive cases with suspected upper mediastinal masses. Intrathoracic goiters were found in 42. The sensitivity, specificity, and accuracy of the scintigraphy for intrathoracic goiter were 93% (39/42), 100% (12/12), and 94% (51/54), respectively. Scintigraphic morphology, scanning technique, and pitfalls are discussed. The results show that most intrathoracic goiters do have thyroid function and that radioiodine scintigraphy is a definitive and cost-effective diagnostic procedure for this disease.

Adult↗
PubMed1991

High-attenuation mediastinal masses on unenhanced CT.

On unenhanced CT scans, a variety of mediastinal masses contain areas with attenuation values higher than the attenuation value of the chest wall musculature. The increased attenuation may be diffuse or focal and may be a result of calcium deposition, high iodine content, or areas of acute hemorrhage. This report illustrates the gamut of high-attenuation mediastinal masses seen on unenhanced CT. Masses that are of high attenuation only on IV contrast-enhanced images (e.g., aberrant vessels) are not included.

Aortic Aneurysm↗