Cervical Approach for Retrosternal Struma: A Case Report
DOI:
https://doi.org/10.35790/msj.v7i2.58670Abstract
Abstract: Retrosternal struma is the inclusion of the thyroid gland into the thoracic cavity. Combined access with a neck incision and chest incision or only a neck incision to free the tumor from the chest cavity and avoid damage to surrounding tissues, makes treatment of substernal struma a challenge both preoperatively and during surgery. Systematic technique minimizes the need for sternotomy, even in patients with significant intra thoracic components, and keeps severe complication rates at levels comparable to those of conventional thyroidectomy. We reported a 46-year-old woman complaining of lumps on the right and left neck for six years. The masses were found on the right side of the neck (10x6cm) and on the left side of the neck (4x3cm), which were hard consistency, well-defined, immobile, skin-colored, painless, and moving when swallowing. CT-scan showed a solid mass struma that had entered the superior thoracic aperture. Total thyroidectomy was performed through cervical approach with a good outcome. In conclusion, total thyroidectomy through a cervical approach is able to remove the entire thyroid gland tissue extending to the retrosternal region with a good outcome without performing a sternotomy.
Keywords: retrosternal struma; thyroidectomy; cervical approach
References
Simó R, Nixon IJ, Vander Poorten V, Quer M, Shaha AR, Sanabria A, et al. Surgical management of intrathoracic goitres. Eur Arch Otorhinolaryngol. 2019;276(2):305-14. Doi:10.1007/s00405-018-5213-z
Sheng YR, Xi RC. Surgical approach and technique in retrosternal goiter: case report and review of the literature. Ann Med Surg (Lond). 2015;5:90-2. Doi: 10.1016/j.amsu.2015.12.057
Knobel M. An overview of retrosternal goiter. J Endocrinol Invest. 2021;44(4):679-691. Available from: https://doi.org/10.1007/s40618-020-01391-6
Cappellacci F, Canu GL, Rossi L, De palma A, Mavromati M, Kuczma P, et al. Differences in surgical outcomes between cervical goiter and retrosternal goiter: an international, multicentric evaluation. Front Surg. 2021;11:1341683. Doi 10.3389/fsurg.2024.1341683
Mawardi M, Maranatha D. Seorang penderita dengan retrosternal goiter. Jurnal Respirasi. 2016;2(1):14-24. Doi: https://doi.org/10.20473/jr.v2-I.1.2016.14-23
Yong JS, Loh KS, Petersson BF, Thong M. Multinodular goiter: a study of malignancy risk in nondominant nodules. ENT-Ear Nose Throat J. 2017;96(9):336-342. Doi: 10.1177/014556131709600821
Alkabban FM, Patel BC. Nontoxic Goiter. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482274/
Can AS, Rehman A. Goiter. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562161/
Singh G, Anastasopoulou C, Correa R. Diffuse toxic goiter. [Updated 2023 Feb 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/ books/NBK557859/
Mauriello C, Marte G, Canfora A, Napolitano S, Pezzolla A, Gambardella C, et al. Bilateral benign multinodular goiter: What is the adequate surgical therapy? A review of literature. Int J Surg. 2016;28(Suppl 1):S7–12. Doi:10.1016/j.ijsu.2016.07.067.
Hafez MT, Abdelmaksoud MM, Awny S, Jamjoom AO, Emlaadawy Mabdelwahab K. Cervical approach for retro-sternal goiter reaching the arch of the aorta should be always your first option. Med J Cairo Univ. 2021;89(6):2403-9. Doi: 10.21608/mjcu.2021.216074
Wang X, Zhou Y, Li C, Cai Y, He T, Sun R, et al. Surgery for retrosternal goiter: cervical approach. Gland Surg. 2020;9(2):392-400. Doi: 10.21037/gs.2020.03.43
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Sherly Tandililing, Edwin Z. Sipayung
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
COPYRIGHT
Authors who publish with this journal agree to the following terms:
Authors hold their copyright and grant this journal the privilege of first publication, with the work simultaneously licensed under a Creative Commons Attribution License that permits others to impart the work with an acknowledgment of the work's origin and initial publication by this journal.
Authors can enter into separate or additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (for example, post it to an institutional repository or publish it in a book), with an acknowledgment of its underlying publication in this journal.
Authors are permitted and encouraged to post their work online (for example, in institutional repositories or on their website) as it can lead to productive exchanges, as well as earlier and greater citation of the published work (See The Effect of Open Access).
