scholarly journals Surgical treatment of substernal goiters extending to posterior mediastinum

2018 ◽  
Author(s):  
Yao Peng ◽  
Xinying Li ◽  
Zhejia Zhang ◽  
Bo Jiang ◽  
Tiecheng Feng ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Present Report ◽  
Treatment Strategies ◽  
Posterior Mediastinum ◽  
Anterior Mediastinum ◽  
Surgical Removal ◽  
Thoracoscopic Approach ◽  
Cervical Approach ◽  
Posterior Mediastinal ◽  
Surgery Department

Introduction: Substernal goiters (SSGs) extending to posterior mediastinum which account for minority of total SSGs. In previous published reports, thoracic approaches were considered to surgical treatment for posterior medastinal goiter in most cases. The present report was to identify the clinical features of posterior mediastinal goiters and surgical treatment strategies on the basis of our experiences. Case presentation: Clinical data of 23 cases of posterior mediastinal goiters in 122 substernal goiters (SSGs) from a total of 4381 thyroidectomies performed in Division of thyroid surgery General Surgery Department of Xiangya hospital, Central South University, China over a 6-year period (2010-2016) was respectively were analyzed. Posterior mediastinal goiters have more prevalence of compression symptoms compared with anterior mediastinal goiters (P<0.05). SSGs which extend to posterior mediastinum have a higher probability of mass bottom below the aortic arch than those extending to anterior mediastinum (P<0.05). Twenty posterior mediastinal goiters (87.0%) underwent thyroidectomies by cervical approach without additional incision. In 3 of the 23 patients (13.0%), 1 thoracotomy and 2 thoracoscopic approaches were performed for a complete and safe removal. Postoperative complications occurred in 5 of 23 patients (21.7%) including temporary recurrent laryngeal nerve (RLN) paralysis and transient hypoparathyroidism in our series. Conclusion: Surgical removal of posterior mediastinal goiters can be performed safely by a single cervical approach in the majority of patients. Thoracoscopic approach proposes a new treatment strategy with feasibility.

scholarly journals Angiofibrolipoma of Posterior Mediastinum with Transforaminal Extension

Rare Tumors ◽  
2016 ◽  
Vol 9 (1) ◽  
pp. 31-33
Author(s):  
Monia Attia ◽  
Imen Megdiche ◽  
Henda Neji ◽  
Ameur Belhadj ◽  
Ines Baccouche ◽  
...  
Keyword(s):  
Present Report ◽  
Final Diagnosis ◽  
Posterior Mediastinum ◽  
Obtuse Angle ◽  
Thoracic Vertebrae ◽  
Histological Variant ◽  
Subcutaneous Tissues ◽  
Posterior Mediastinal ◽  
The Right ◽  
Upper Mediastinum

Angiofibrolipoma is a histological variant of lipoma, which commonly occurs in subcutaneous tissues. In the present report we illustrate the case of an angiofibrolipoma of the posterior upper mediastinum in a 75-year-old man presented with progressive chest pain. Xray chest showed a homogeneous opacity vertically oriented along the right lateral aspect of thoracic vertebrae with an obtuse angle to the mediastinum. The upper extremity of the mass extended above the superior clavicle, suggestive of a posterior mediastinal lesion. Thoracic magnetic resonance imaging revealed a posterior mediastinal mass, in keeping with a nonaggressive lesion, with particular endocanalar extension and heterogeneous signal and enhancement patterns that was highly suggestive of a mixed mesenchymal tumor. The tumor was incompletely removed by right postero-lateral thoracotomy with final diagnosis of angiofibrolipoma. To the author's knowledge, such a case of angiofibrolipoma located in the posterior mediastinum has not been previously reported in the literature.

Posterior Mediastinal Goiter Removal Through Cervical Incision

2021 ◽  
pp. 000313482110335
Author(s):  
Komal Gupta ◽  
Neha Gupta ◽  
Kamal Kataria
Keyword(s):  
Posterior Mediastinum ◽  
Intrathoracic Goiter ◽  
Adenomatous Goiter ◽  
Vessel Sealing ◽  
Cervical Incision ◽  
Cervical Approach ◽  
Posterior Mediastinal ◽  
Case Basis ◽  
Lateral Thoracotomy ◽  
Mediastinal Goiter

Intrathoracic goiter when encountered can be treated by thyroidectomy using cervical incision, only occasionally requiring extra cervical approach. We are reporting one such case in a patient with pituitary macroadenoma with extension of the adenomatous goiter into the posterior mediastinum. It was removed through the cervical collar incision using a vessel sealing device. There were no intraoperative and postoperative complications during the procedure. The need for extra cervical incision should be decided on a case-to-case basis to avoid the increased morbidity associated with sternotomy and lateral thoracotomy incision.

scholarly journals Primary intrathoracic goiter: a rare mediastinal tumor

2017 ◽  
Vol 4 (6) ◽  
pp. 1833
Author(s):  
Hazem Zribi ◽  
Amina Abdelkbir ◽  
Sarra Maazaoui ◽  
Imen Bouacida ◽  
Hanen Smadhi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Thoracic Surgery ◽  
Postoperative Complication ◽  
Mediastinal Tumor ◽  
Posterior Mediastinum ◽  
Anterior Mediastinum ◽  
Transthoracic Approach ◽  
Intrathoracic Goiter ◽  
Cervical Approach ◽  
The Right

Background: Substernal goiters are usually classified as secondary or primary intrathoracic goiters. Primary ones result from an abnormal embryologic migration of the thyroid and represents less than 1% of all goiters. Secondary substernal goiters develop from the descent of the thyroid into the mediastinum and represents 98-99% of goiters.Methods: This was a retrospective study which discuss the symptoms, the diagnosis and the treatment of 7 primary intrathoracic goiters.Results: Goiter was located in the anterior mediastinum in 5 cases, in the posterior mediastinum in 1 case and in the medium mediastinum in 1 case. The mass was located on the right in 5 cases cervical approach was performed in 3 cases. Two patients required a transthoracic approach, 1 required sternotomy and in 1 case video-thoracic surgery was sufficient. Only one patient had postoperative complication which was secondary pneumothorax. All tumors were benign.Conclusions: Mediastinal ectopic goitre is rare. However it should be discussed among the different etiologies of mediastinal masses.

scholarly journals Giant retrosternal goiter masquerading as, right posterior mediastinal mass: a rare case report

2019 ◽  
Vol 7 (1) ◽  
pp. 306
Author(s):  
Jaykumar N. Punjani ◽  
Kesha K. Shah ◽  
Arun Kumar Haridas
Keyword(s):  
Thyroid Gland ◽  
Mediastinal Mass ◽  
Thyroid Tissue ◽  
Posterior Mediastinum ◽  
Surgical Removal ◽  
Thyroid Function Tests ◽  
Posterior Mediastinal Mass ◽  
Complete Surgical Excision ◽  
Retrosternal Goiter ◽  
Posterior Mediastinal

Complete mediastinal plunging thyroid gland is a rare entity, accounting for 1% of all mediastinal tumours, particularly posterior mediastinal tumour much more rare. We would like to present, a 30-year-old lady presented to ENT department with neck swelling and its further investigation shown to be giant posterior mediastinal mass. Thyroid function tests were normal. CT scans of the neck and chest revealed a large right mediastinal mass compressing the trachea from the right side and extending to the superior part of the posterior mediastinum with enlarged right thyroid gland in the cervical position. Midline extended sternotomy was done for complete surgical excision of the mass along with right hemi thyroidectomy. It was well circumscribed, capsulated, multinodular firm inconsistency, and vascular. Histopathology revealed thyroid tissue negative for malignancy. Giant plunging thyroid in the mediastinum is very rare. It should be differentiated from other mediastinal mass. The plunging goiter in posterior mediastinum is surgically challenging. Transsternal surgical removal is the treatment of choice in such cases.

scholarly journals Case Report: Modified Thoracoscopic-Assisted Cervical Resection for Retrosternal Goiter

2021 ◽  
Vol 8 ◽  
Author(s):  
Cédric Nesti ◽  
Benny Wohlfarth ◽  
Yves M. Borbély ◽  
Reto M. Kaderli
Keyword(s):  
Endocrine Surgery ◽  
Thyroid Lobe ◽  
Thoracic Inlet ◽  
Thoracoscopic Approach ◽  
Mediastinal Dissection ◽  
Retrosternal Goiter ◽  
Cervical Approach ◽  
Posterior Mediastinal ◽  
The Right ◽  
Mediastinal Extension

Introduction: The treatment of choice for retrosternal goiters (RSG) is surgical resection to relieve symptoms and rule out malignancy. Although the majority of RSG can be removed by a cervical approach only, an extracervical approach (e.g., sternotomy, thoracotomy or thoracoscopy) may be required. Herein, we describe a refined thoracoscopic-assisted cervical two-team RSG resection without thoracoscopic mediastinal dissection.Technique: A 57-year-old man presented with a large RSG with posterior mediastinal extension (PME) and extensive peritumoral vascularization. Due to its extension below the aortic arch and its small connection with the right thyroid lobe, a combined cervical and thoracoscopic approach was intended. The endocrine surgery unit performed the cervical mobilization of the right thyroid lobe, while the thoracic surgery unit gently pushed the mediastinal tumor through the thoracic inlet without performing mediastinal dissection. This allowed a safe visualization of the inserting vessels by the endocrine surgery team at the neck, followed by a stepwise division of the vessels and resection of the retrosternal nodule through the cervical access.Comment: The described approach is indicated for RSG with posterior mediastinal extension, anteroposterior dimension smaller than the thoracic inlet and inaccessibility from a cervical approach only. This minimally invasive approach is associated with a faster recovery, decreased morbidity and postoperative pain, shorter hospital stay and better cosmetic results.

scholarly journals Posterior Mediastinal Adenomatoid Tumor: A Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Vishwas Parekh ◽  
Thomas Winokur ◽  
Robert J. Cerfolio ◽  
Todd M. Stevens
Keyword(s):  
Benign Neoplasm ◽  
Good Health ◽  
Posterior Mediastinum ◽  
Anterior Mediastinum ◽  
Caucasian Woman ◽  
Adenomatoid Tumor ◽  
First Case ◽  
Eosinophilic Cytoplasm ◽  
Posterior Mediastinal ◽  
Mitotic Figures

Adenomatoid tumor is an uncommon benign neoplasm of mesothelial differentiation that distinctively arises in and around the genital organs. In rare instances, it has been described in extragenital locations. There have been only two reports documenting its occurrence in the anterior mediastinum, and no reports documenting its occurrence in the posterior mediastinum. We report the first case of posterior mediastinal adenomatoid tumor. A 37-year-old Caucasian woman presented with symptoms of bronchitis. Imaging studies identified a 2.0 cm posterior mediastinal mass abutting the T9 vertebral body, clinically and radiologically most consistent with schwannoma. Histologic sections revealed a lesion composed of epithelioid cells arranged in cords and luminal profiles embedded in a fibrotic to loose stroma and surrounded by a fibrous pseudocapsule. Lesional cells showed vacuolated eosinophilic cytoplasm and peripherally displaced nuclei with prominent nucleoli. There was focal cytologic atypia but no mitotic figures or necrosis was identified. The lesional cells expressed cytokeratin, calretinin, and nuclear WT1 but were negative for PAX8, TTF1, p53, chromogranin, CD31, and CD34, and Ki67 showed <2% proliferation rate, diagnostic of adenomatoid tumor. Three years after resection, the patient is in good health without tumor recurrence. Thus, our encounter effectively expands the differential diagnosis of posterior mediastinal neoplastic entities.

scholarly journals STRUMA MULTI NODOSA NON TOKSIKA INTRATHORAKAL Apa pilihan approach operasinya? Haruskah dilakukan Median Sternotomy?

2012 ◽  
Vol 1 (2) ◽  
Author(s):  
Mochamad Aleq Sander ◽  
Fina CS
Keyword(s):  
Thyroid Gland ◽  
Blood Supply ◽  
Internal Mammary Artery ◽  
Median Sternotomy ◽  
Posterior Mediastinum ◽  
Anatomic Location ◽  
Internal Mammary ◽  
Cervical Approach ◽  
Posterior Mediastinal

Mochamad Aleq Sander, dr., M.Kes., SpB., FinaCSFakultas Kedokteran Universitas Muhammadiyah MalangJl. Bendungan Sutami 188A Malang 65145e-mail: [email protected]: bedahunmuh.wordpress.comAbstractIntrathoracal non toxic multi nodular struma is lumpy enlargement of thyroid glandwithout hypothyroidism that extend from cervical thyroid gland into thoracal cavity. Accordingto anatomy location of thyroid, their name were substernal, retrosternal, mediastinal,intrathoracal, plunging, anterior and posterior mediastinal, and aberrant mediastinal. Theorigin of blood supply of mediastinal struma was inferior thyroidea artery, especially casesfrom aorta, subclavia artery, internal mammary artery, or ima thyroidea artery. According toStudy got that seven patients with mediastinal struma had intrathoracal blood supply directly.Surgery could cervical approach and/or thoracotomy according to anatomic location andtype of intrathoracal struma.Keywords: intrathoracal strumaAbstrakStruma multi nodosa non toksika intratorakal adalah pembesaran kelenjar tiroid yang tampakberbenjol-benjol tanpa disertai tanda-tanda hipertiroidisme yang mengalami ekstensi kearahinferior dari kelenjar tiroid servikal hingga masuk ke dalam rongga thoraks. Jaringan tiroidyang berada di rongga toraks diberi nama sesuai tempat anatominya yaitu substernal, retrosternal,mediastinal, intrathorakal, plunging, anterior dan posterior mediastinum, serta mediastinumaberrant. Suplai darah untuk struma mediastinum biasanya dari arteri tiroidea inferior, padakasus tertentu suplai darah dapat berasal dari aorta, arteri subklavia, arteri mamaria interna,atau dari arteri tiroidea ima. Hasil penelitian didapatkan bahwa dari tujuh orang yang mengalamistruma mediastinum ternyata memiliki sumber perdarahan langsung dari intrathorakal. Tindakanoperasinya bisa melalui cervical approach dan/atau thoracotomy, hal ini tergantung dari lokasianatomis dan tipe struma intratorakal yang diderita oleh pasien.Kata kunci: struma intratorakal

scholarly journals A Rare Case of Posterior Mediastinal Seminoma Mimicking Primary Lung Neoplasm

2013 ◽  
Vol 1 (2) ◽  
pp. 39
Author(s):  
Sian Yik Lim ◽  
Grerk Sutamtewagul ◽  
Ragesh Panikkath ◽  
Fred Hardwicke
Keyword(s):  
Rare Case ◽  
Lung Neoplasm ◽  
Posterior Mediastinum ◽  
Anterior Mediastinum ◽  
Diagnostic Challenge ◽  
Rare Form ◽  
Poorly Differentiated Carcinoma ◽  
Posterior Mediastinal ◽  
Poorly Differentiated ◽  
Mediastinal Seminoma

We report an atypical case of posterior mediastinal seminoma. Mediastinal seminomasare a rare form of tumor usually located in the anterior mediastinum. Our casepresented as a diagnostic challenge because of the difficulty of differentiating the primarymediastinal mass from a primary lung neoplasm. Our case highlights the fact thatseminomas may occur in the posterior mediastinum and the importance of consideringa broad differential diagnosis, especially in cases of poorly differentiated carcinoma ofthe mediastinum.

Surgical treatment strategies for secondary peritonitis: Outcome in 278 patients

2001 ◽  
Vol 120 (5) ◽  
pp. A401-A401
Author(s):  
M BOERMEESTER ◽  
E BELT ◽  
B LAMME ◽  
M LUBBERS ◽  
J KESECIOGLU ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Strategies ◽  
Secondary Peritonitis

Surgical treatment of transmissible venereal tumor (sticker sarcoma)

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Bougherara Hithem ◽  
Boukhechem Saïd ◽  
Aguezlane Abdelaziz ◽  
Benelhadj Khouloud ◽  
Aissi Adel
Keyword(s):  
Surgical Treatment ◽  
Cancer Cells ◽  
Treatment Method ◽  
High Rate ◽  
Surgical Removal ◽  
Characteristic Appearance ◽  
Recurrent Tumors ◽  
External Genital Organs

Background: Sticker sarcoma, also called venereal sarcoma or venereal lymphosarcomatosis, is a tumor of the external genital organs in females and males. In male animals the penis and foreskin (prepuce) are affected, in the female, it happens in vagina (vagina) and labia (vulva). The diagnosis of sticker sarcoma is based on the chronic discharge, the typical locations and the characteristic appearance of the tumor. Methods: We have relied on the treatment method on the complete surgical removal of all cancer cells that we can access. Results: After surgery, we notice recurrent tumors about six months after surgical treatment, indicating the need for other treatments in addition to surgery. Conclusion: Although spontaneous regressions of sticker sarcoma are documented (with permanent immunity), chemotherapy is the treatment of choice today. Irradiation should also be effective. If the tumor is only removed surgically, there is a high rate of recurrence, and this is what happened with the case that we treated, as the tumor reappeared after less than six months.

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