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2.1
Substernal Goiter
Goiter Substernal

Presentation

This report describes the clinical course of a 44-year-old woman who presented with this entity and was successfully corrected by surgical intervention. A discussion of diagnostic, operative, and prognostic considerations is presented. [ncbi.nlm.nih.gov]

Pulmonary function tests were performed in eight patients (36.7%) who presented with dyspnea. [thoracicmedicine.org]

In the present study, prevalence of Retrosternal goiter was 9%. [alliedacademies.org]

Entire Body System

  • Goiter

    OBJECTIVE: This study aims to compare the prevalence of laryngopharyngeal reflux signs between two groups of patients undergoing thyroidectomy for voluminous goiter: substernal goiters and voluminous cervical goiter without thoracic extension. [ncbi.nlm.nih.gov]

  • Soft Tissue Mass

    Chest radiographs showed tracheal deviation in 79 percent and soft tissue mass in 56 percent. [ncbi.nlm.nih.gov]

    […] is typically well-encapsulated and may show degeneration (calcification) • Most patients are asymptomatic Imaging • Sharply defined, smooth or lobulated soft tissue mass which characteristically displaces the trachea • They do not usually project below [learningradiology.com]

    Radiography can show soft tissue masses, tracheal deviation, and calcifications in thyroid. Radiography findings; however, have neither sensitivity nor specificity. [alliedacademies.org]

  • Multiple Organ Dysfunction Syndrome

    The patient was once again placed under inotropic support with noradrenaline but deteriorated day-by-day and developed multiple organ dysfunction syndrome due to sepsis. The patient died on the 17 th postoperative day. [scielo.br]

Respiratoric

  • Tracheal Deviation

    Chest radiographs showed tracheal deviation in 79 percent and soft tissue mass in 56 percent. [ncbi.nlm.nih.gov]

Urogenital

  • Cervical Enlargement

    After this cervical enlargement, expansion may extend into the mediastinum, resulting in compression of the structures within the thoracic inlet. [optecoto.com]

Workup

This study was carried out to evaluate the clinical presentation, workup, surgical complications, and risk of malignancy for substernal goiter. [ncbi.nlm.nih.gov]

[…] atteggiamento terapeutico il cui obiettivo e duplice: risolvere la sinto - matologia prodotta dalla massa mediastinica ed escludere la possibi - lita di recidive • We reviewed the cases of 52 patients with substernal goiters to examine clinical presentation, workup [scinapse.io]

This discordance requires further workup to exclude malignancy. FigurE 6-19. Colloid goiter. Clinically palpable goiter in a patient who grew up in a Michigan goiter belt. Inhomogeneous tracer distribution with multiple focal cold areas. [passeidireto.com]

Workup All patients underwent thyroid function test, US guided FNAC, USG neck, CECT scan, Thyroid scan. On FNAC, all patients were reported as benign nodular goiter. All patients were biochemically and clinically euthyroid. [medcraveonline.com]

X-Ray

  • Mediastinal Mass

    More info Substernal Goiter: Rare Cause of Anterior Mediastinal Masses. Substernal Goiter: Rare Cause of Anterior Mediastinal Masses. [thyroidnosurgery.com]

    A pulmonary perfusion defect was caused by an extremely large anterior mediastinal mass subsequently proved by I-131 imaging to be an intrathoracic extension of a cervical goiter. [ncbi.nlm.nih.gov]

    The 24-hour iodine uptake of the thyroid gland (excluding the mediastinal mass) was slightly low at 10.9%. [healio.com]

  • Superior Mediastinal Mass

    Goiters account for as many as 10–15% of space-occupying mediastinal lesions and are the most common of the superior mediastinal masses. Mediastinal goiters are classified as primary or secondary. [accesssurgery.mhmedical.com]

    The results of the present study indicated that 100% of the findings obtained from chest x-ray had tracheal deviation, and in 100% of the findings obtained from CT scan, there were superior mediastinal mass, tracheal deviation and tracheal stenosis. [alliedacademies.org]

Treatment

In addition, even in those regions where they are less common, knowledge of their treatment is important as they can represent up to 7% of mediastinal tumors. [ncbi.nlm.nih.gov]

Prognosis

The prognosis depends on a good preoperative preparation and rigorous postoperative follow-up. [endocrine-abstracts.org]

Treatment and prognosis Most anterior substernal thyroid goitres are accessed via a transcervical approach. [radiopaedia.org]

Prognosis No studies are available regarding the natural history of substernal goiter, nor those that compare expectant monitoring with surgery. [1] Complications Complications of untreated substernal goiters occur primarily because of compression of [emedicine.medscape.com]

The chapter starts with general information of ankle and foot pain, known risk factors and prognosis. [mijn.bsl.nl]

Etiology

EN In this article, the difficulties in treatment of 18 patients with intrathoracic thyroid goiters were discussed.The aim of the study were: defining the etiology and symptomology of goiters within the chest in the own material, conducting the analysis [psjd.icm.edu.pl]

Hypothyroidism has multiple etiologies and manifestations. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions. [aace.com]

Read Summary - More: Guidance 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis 01 August 2016 - Publisher: American Thyroid Association Thyrotoxicosis has multiple etiologies [evidence.nhs.uk]

Substernal goiters represent up to 7% of mediastinal tumors. [5] In general, the diagnosis is made in individuals older than 50 years, and has a female predominance four-fold over males. [1] Etiology Most (85-95%) substernal thyroid masses represent benign [emedicine.medscape.com]

ETIOLOGY Iodine deficiency is the most common cause of goiter worldwide. [uptodate.com]

Epidemiology

The purpose of this study was to analyze the epidemiological, clinical and paraclinical profile of substernal goiter and the difficulties of management. MATERIAL AND METHODS: A retrospective study included 50 cases from our ENT department. [ncbi.nlm.nih.gov]

Epidemiology The incidence of substernal goiter is difficult to assess but reportedly ranges from 0.2% to 45% of patients undergoing thyroidectomy. [2] The wide range in reported incidence is largely due to variation in the definition of substernal goiter [emedicine.medscape.com]

OF PERITONITIS Medecine et maladies infectieuses BORGONOVO G; AMATO A; VARALDO E; MATTIOLI FP EPIDEMIOLOGY OF PERITONITIS Medecine et maladies infectieuses ARNOLDI A; BASSOLI A; BORGONOVO G; MERLINI L SYNTHESIS AND SWEET TASTE OF OPTICALLY-ACTIVE (-) [serials.unibo.it]

Pathophysiology

Pathophysiology The pathophysiology of goiters is well described in the Medscape Drugs and Diseases article Nontoxic Goiter. [emedicine.medscape.com]

[…] intrathoracic goiter, thoracoscopic resection has also been reported.8 Although the surgical resection can be complicated by intraoperative hemorrhage, major postoperative complications are rarely seen.5 The use of CPB itself initiates a variety of pathophysiologic [ncbi.nlm.nih.gov]

Essentials of pathophysiology: Concepts of altered health states (3rd ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins. ^ Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson (2007). [en.wikipedia.org]

Prevention

This technique seems to offer improved exposure and reliable control of the neuro-vascular structures in the anterior mediastinum when resecting a huge substernal goiter that may prevent nerve injury. [ncbi.nlm.nih.gov]

Downward migration of the thyroid into the mediastinum is facilitated by negative intra-thoracic pressure, gravity, traction forces during swallowing and the presence of anatomical barriers preventing the enlargement in other directions (thyroid cartilage [slideshare.net]

Treatment consists of iodine replacement; although this will not cure the condition, it can stop it from enlarging, and iodine administered in advance will prevent development of goiter. exophthalmic goiter any type accompanied by exophthalmos. fibrous [medical-dictionary.thefreedictionary.com]

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