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India

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Forgotten thyroid is retrosternal portion of thyroid gland which is connected to cervical portion of thyroid with or without a thin fibrous band or vascular structure and not realized or forgotten during total thyroidectomy. In some cases, cervical portion of thyroid gland goes beyond, with stretched neck to the superior thoracic strait for at least 3 cm that called “retrosternal goiter”

52 year old female patient, hypothyroid, presented to our outpatient department with complaints of pain in the left arm since the last 4 years on and off . Occasional difficulty in breathing. She was evaluated for the same and was diagnosed to have a large retrosternal goitre. She had undergone a subtotal thyroidectomy for multinodular goitre 4 years ago for a multiodular goitre She underwent sternotomy + excision of the goitre by CTVS team. Post operative period was uneventful

Forgotten goiter is usually the consequence of the incomplete removal of a plunging goiter, and moreover, sometimes it may be attributed to a concomitant, unrecognized mediastinal goiter which is not connected to the thyroid.They are usually present in anterior or middle mediastinum commonly and rarely seen in the posterior mediastinum.They are mostly asymptomatic unless they compress upon surrounding structures. They are either classified as primary or secondary retrosternal goitres. These retrosternal goitres derive their blood supply from the mediastinal vessels and seldom from the cervical vessels

Forgotten goiter is a rare pathology which can be prevented if particular attention is paid to preoperative imaging and intraoperative management during the first operation.