Trans-cervical Resection of a Separate Substernal Goitre

Overview

Journal Int J Surg Case Rep

Specialty General Surgery

Date 2017 Nov 21

PMID 29156233

Authors

Henry To

Antara Karmakar

Stephen Farrell

Steve Manolas

Affiliations

Soon will be listed here.

Abstract

Introduction: A separate substernal goitre which is not continuous with the main cervical thyroid proves a unique challenge for resection. A trans-cervical approach is preferred but may be hazardous due to the possibility of ectopic thyroid tissue with alternate blood supply.

Presentation Of Case: A 72year old female who had a previous left hemithyroidectomy presents with a symptomatic central substernal thyroid mass. Following radiological work-up, the separate goitre was carefully removed via a trans-cervical approach and avoidance of sternotomy. She had a rapid recovery without complication.

Discussion: The anatomy and embryology of substernal masses need to be carefully considered particularly if the mass is ectopic thyroid tissue. Careful pre-operative assessment may determine its nature and anatomical features. Intra-operative dissection requires consideration of blood supply and surrounding structures, but often may be and is best completed via a cervical approach to minimise morbidity. Review of the literature affirms the preference for a trans-cervical approach and offers criteria for successful resection via this method.

Conclusion: Confirming the nature and anatomy of a separate substernal goitre enables successful removal of the mass via a trans-cervical approach with minimal morbidity.

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