Keywords
Endothoracic
Thoracotomy
How to Cite
Abstract
Introduction : Neglected endothoracic goiter is an endothoracic mediastinal portion that was neglected during the surgical removal of a plunging cervical goiter in contrast to autonomous ectopic mediastinal goiter which has its own mediastinal vascularization without connection between the two components and but who was not diagnosed during the cervical thyroidectomy. The aim of this work is to report the point of view of thoracic surgeon to avoid "forgetting" this endothoracic component.
Materiel and methods : This is a retrospective study involving four patients, all operated for an endothoracic goiter only by thoracotomy.
Results : Among four patients, it was 3 women and one men with an average age of 46 years. All Four cases have already been operated for cervical goiter by cervicotomy alone. Also, for all patients, the discovery was accidental. the cervicothoracic scan found a posterior mediastinal heterogeneous mass, with calcification lesions in 2 patients, and necrosis zone in 2 patients. The four patients were operated by posterolateral thoracotomy. Operative outcome was simple in all patients except 2 cases of wound infection.
Conclusion : Neglected endothoracic goiter poses a diagnostic and also a therapeutic problem because its a difficult surgery due to the adhesions already formed following a first cervical thyroid surgery and therefore it is essential not to miss the diagnosis of any diving goiter.
References
Haller A. Disputatones Anatomica Selectae. Gottingen, Germany. Endenhoeck. 1749.
Patel KM, Parsons CC. Forgotten goiter: Diagnosis and management. A case report and literature review. Int J Surg Case Rep. 2016;27:192 4. https://doi.org/10.1016/j.ijscr.2016.08.036
Casadei R, Perenze B, Calculli L, Minni F, Conti A, Marrano D, et al. “Forgotten” goiter: Clinical case and review of the literature. Chir Ital. Nov-Dec 2002;54(6):855-60.
Daniel C, André N, Leroyer C. Goitre endothoracique. EMC- Pneumologie. 2000 ; 6-047-D-30 : 5.
Janati IM, Jancovici R, Jeanbourquin D, Pailler JL, Cosnard G. Intérêt des examens complémentaires dans lesgoitres plongeants. J Chir. 1990 ; 127 : 575-579.
Illé S, J amesDidié L, Bako I, Sani Rachid. Les goitresPlongeants : Aspects Epidémiologiques, Cliniques, Radiologiques Et Thérapeutiques. Europ Sci J. 2016; 12(30).
Van Schil P, Vanmaele R, Ehlinger P, Schoofs E, Goovaerts G. Primary intrathoracic goiter. Acta Chir Belg. Jul-Aug 1989;89(4):206-8.
Fadel E, Chapelier A, Lancelin C, Macchiarini P, Dartevelle Ph. Les goitres endothoraciques. Presse Med. 1996; 25: 787–92.
Blondeau Ph. Les pièges des prolongements thoraciquesdes goitres cervicaux. Lille Chirurgical. 1979 ; 24 : 37-46.
Nankee L, Chen H, Schneider DF, Sippel RS, Elfenbein DM. Substernal goiter: when is a sternotomy required? J Surgres. 2015 ; 199 : 121-5. https://doi.org/10.1016/j.jss.2015.04.045
Kilic D, Findikcioglu A, Ekici Y, Alemdaroglu U, Hekimoglu K, Hatipoglu A. When is Transthoracic Approach Indicated in Retrosternal Goiters? Ann Thorac Cardiovasc Surg. 2011; 17: 250–253. https://doi.org/10.5761/atcs.oa.10.01541
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2020 Lakranbi M et al.
