GIANT INTRATHORACIC GOITER: MULTIDISCIPLINARY SURGICAL RESECTION WITH OPTIMAL OUTCOME danielbarocio03@gmail.com

PE099

GIANT INTRATHORACIC GOITER: MULTIDISCIPLINARY SURGICAL RESECTION WITH OPTIMAL OUTCOME

6

 

 

 

 

Mexico

Poster Exhibition only

Intrathoracic goiter (ITG) refers to the presence of a significant portion of thyroid tissue extending below the thoracic inlet into the mediastinum. Although uncommon, its clinical relevance lies in the potential compression of mediastinal structures and the risk of malignancy. ITG is more frequent in women (3:1–5:1) between 40 and 60 years old, representing 0.02–0.5% of the general population in countries such as the United States and 3–12% of mediastinal masses.

We report the case of a 71-year-old woman with no chronic comorbidities, presenting with progressive dyspnea on minimal exertion for two weeks, worsening over the last five days, associated with clear rhinorrhea. Physical examination revealed a multinodular goiter. Neck and chest CT demonstrated a massive thyroid mass extending into the mediastinum.

A multidisciplinary surgical team—including general, oncologic, and cardiothoracic surgeons—performed a total thyroidectomy with partial sternotomy. Intraoperative findings included: right lobe 8×6 cm, left lobe 15×8 cm, preservation of the right recurrent laryngeal nerve, and immediate repair of an intraoperatively injured left recurrent laryngeal nerve. Estimated blood loss was 400 mL, and a 19Fr Blake drain was placed. The patient recovered uneventfully and was discharged on postoperative day three.

ITG, though rare, may present with acute airway compromise requiring urgent intervention. This case emphasizes the value of early diagnosis, advanced imaging, and coordinated multidisciplinary surgery to achieve complete resection while preserving vital structures. Proper planning and teamwork can transform a potentially life-threatening condition into a successful surgical outcome.