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Results for “Goiter, Substernal”

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PubMedDate not supplied

Retrosternal goiters: safety of surgical treatment.

Retrosternal goiters still pose a problem to expert endocrine surgeons. Whether surgery should be the treatment of choice or not remains controversial because of hypothetical increased morbidity rates associated with the surgical approach. Eighty-three patients were retrospectively reviewed for anesthetic risk, fibrobronchoscopic guidance for intubation, surgical technique, mortality and morbidity rates, and pathological findings. We found 6.09% of American Society of Anesthesiologists (ASA) I, 41.46% of ASA II, 40.24% of ASA III, and 12.19% of ASA IV risk. Twelve patients (14.45%) required fibrobronchoscopic guidance for intubation. Only one patient required a sternotomy. No mortality occurred. Seven patients (8.43%) had major complications, but there were no instances of permanent recurrent laryngeal palsy or hypocalcemia. Pathological examination revealed 9.63% incidence of malignancy. Surgery should be the treatment of choice for retrosternal goiters because there is a significant incidence of malignancy and an acceptable morbidity rate.

Adult↗
PubMedDate not supplied

Pleural effusion as a complication of intrathoracic goitre.

The authors report their experience with a case of bilateral pleural effusions as a complication of intrathoracic goitre. They then go on to examine all the possible causes of this phenomenon. After discussing the anatomy of the superior mediastinum, they conclude that hydrothorax related to intrathoracic goitre could be the result of pressure of the mass on venous structures, especially on the superior vena cava, or on the intramediastinal lymphatic vessles, or, as in the case reported, on both.

Aged↗
PubMed2004

[Giant euthyreotic retrosternal struma complicated by compression and thrombosis of brachiocephalic, subclavia, jugular and axillary veins, edema and necrosis of brain].

The case of giant euthyreotic retro-sternal struma complicated by compression and thrombosis of brachiocephalic, subclavia, jugular and axillary veins, edema and necrosis of brain is presented in the article. 64-year-old man was admitted to the hospital due to ischemic stroke. Retrosternal struma was suspected according to clinical symptoms of compression of superior vena cava. Due to progression of neurologic symptoms the patient died. During autopsy giant euthyreotic retrosternal struma complicated by compression and thrombosis of brachiocephalic, subclavia, jugular and axillary veins, edema and necrosis of brain was found. Timely established diagnosis and effective surgical treatment of retrosternal struma could prevent such dangerous complications as edema and necrosis of the brain.

Autopsy↗
PubMed2004

Ectopic intrathoracic thyroid: case report.

We present a patient with ectopic intrathoracic thyroid that was removed through a right lateral thoracotomy. Ectopic intrathoracic thyroid is a rare presentation of thyroid disease and comprises about 1% of all mediastinal tumors. Its removal usually necessitates thoracotomy or sternotomy. The relevant literature is briefly reviewed.

Adult↗
PubMed2003

[Diagnosis and treatment of retrosternal goiter].

Retrosternal and intrathoracal goiters are actual surgical problem. This is because of the severe clinical symptoms, complications and some difficulties at the operative treatment. For the period of 1991-2002 at the Clinic of Thoraco-Abdominal Surgery at Medical University Plovdiv are operated 1131 patients with thyroid disease. Of them 38 were operated with cervical incision, 3 with median sternotomy, 2 with thoracotomy. There were complication at 7 patients. Only one patient died from pulmonary embolism.

Adult↗
PubMedDate not supplied

Management of retrosternal goiters: experience of a surgical unit.

The aim of this study was to retrospectively analyze 5 years' experience of cervico-mediastinal goiters (CMG) management. Twenty-five patients with cervico-mediastinal goiters underwent surgery between January 1998 and December 2002. The group consisted of 16 females and 9 males (mean age, 48.2 years; range, 42-74 years). A total thyroidectomy under general anesthesia was always performed. A no. 7 Fogarty catheter with a 5-ml balloon was employed in the seven last cases to lift the retrosternal portion of the goiter into the neck. The mean postoperative stay was 3 days (range, 1-7 days), and the mean follow-up time was 29 months (range, 1-58 months). There were no postoperative deaths; overall morbidity rate was 28.0%. One patient with a severe life-threatening hematoma required surgical re-exploration. Surgery for CMGs shows a low morbidity rate; total thyroidectomy is the treatment of choice to prevent recurrences or re-surgery for malignancy.

Adult↗
PubMed1992

[Anesthesiology problems in the surgery of cervico-mediastinal goiter. Our clinical experience].

The Authors, after explaining the difficulties that an anaesthetist finds in cervical-mediastinum goitre surgery, report their own experience. Even if limited, it shows the full validity of a methodology of using a very efficacious drug for good cardiovascular stability. Moreover, we must take into account the constant attention the anaesthetist must pay in some essential moments of general anaesthesia such as intubation, patient position and monitoring.

Aged↗
PubMed1992

[A case of anaplastic carcinoma of the mediastinal goiter].

We reported a case of anaplastic carcinoma of mediastinal goiter. The initial symptom was hoarseness, and thyroid scintigram and venogram revealed mediastinal thyroid malignant tumor, although cervical tumor could not be palpated. Operation was performed with median sternotomy. The size of the tumor was 8 x 6 x 3cm. Histological examination showed papillary adenocarcinoma of left lower pole of the thyroid gland which was transformed into anaplastic carcinoma and extended to the mediastinal cavity. Anaplastic carcinoma of mediastinal goiter is very rare, and our case showed anaplastic transformation from papillary adenocarcinoma.

Adenocarcinoma, Papillary↗