Primary Ectopic Mediastinal Goiter Combined with Papillary Microcarcinoma of the Cervical Thyroid Gland / 대한내분비외과학회지

True primary mediastinal ectopic goiters are quite rare, and they occur in less than 1% of all goiters. We report here on a case in which a primary mediastinal ectopic goiter was accompanied with papillary microcarcinoma of the cervical thyroid. The mediastinal ectopic goiter was not connected to the cervical thyroid and its blood was supplied from intrathoracic vessels, which necessitated a thoracotomy or sternotomy for removal rather than a standard cervical collar incision. We performed total thyroidectomy for the papillary microcarcinoma of the cervical thyroid gland and transsternal removal for the mediastinal goiter; this resulted in a favorable outcome.

Forgotten Mediastinal Goiter / 대한내분비외과학회지

Forgotten mediastinal goiter is an extremely rare disease. It is most often the consequence of the incomplete removal of a ‘ plunging’ goiter, but it can sometimes be attributed to a concomitant, unrecongnized primary mediastinal goiter which is not connected to the thyroid. A primary mediastinal goiter(autonomous intrathoracic goiter) essentially caused by an abnormal embryonic development of the thyroid gland and a thyroid gland formation located in the thorax or the mediastinum. The differential diagnosis with ordinary recurrence was based on the absence of parenchymatous or vascular connections with the cervical thyroid gland. It is fed by local intrathoracic vessels and observed in the absence of previous thyroidectomy. Nevertheless, for primary mediastinal goiter, sternum-splitting incision will be required in most cases as troublesome mediastinal bleeding may occur which is difficult to control from a cervical collar incision. In this study we report a case of forgotten mediastinal goiter and review the various diagnostic and therapeutic problems posed by the condition. A number of possible solutions that can be implemented for this diasease are identified.