The “forgotten” goiter after total thyroidectomy

Abstract INTRODUCTION “Forgotten” goiter is an extremely rare disease which is defined as a mediastinal thyroid mass found after total thyroidectomy. PRESENTATION OF CASE We report two cases with forgotten goiter. One underwent total thyroidectomy due to thyroid papillary cancer and TSH level was in...

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Bibliographic Details
Published in:International journal of surgery case reports 2013-01, Vol.4 (3), p.269-271
Main Authors: Sahbaz, Alper, Aksakal, Nihat, Ozcinar, Beyza, Onuray, Feyyaz, Caglayan, Kasim, Erbil, Yesim
Format: Article
Language:English
Subjects:
Forgotten goiter
Retrosternal goiter
Substernal goiter
Surgery
Total thyroidectomy
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Summary:Abstract INTRODUCTION “Forgotten” goiter is an extremely rare disease which is defined as a mediastinal thyroid mass found after total thyroidectomy. PRESENTATION OF CASE We report two cases with forgotten goiter. One underwent total thyroidectomy due to thyroid papillary cancer and TSH level was in normal range one month after surgery. The thyroid scintigraphy scan revealed mediastinal thyroid mass. The second case underwent total thyroidectomy due to Graves’ disease and TSH level was low after surgery. At postoperative seventh year, patients were admitted to our Endocrinology Division due to persistent hyperthyroidism and CT scan revealed forgotten thyroid at mediastinum. Both patients underwent median sternotomy and mass excision, there was no morbidity detected after second surgical procedures. DISCUSSION In the majority of cases forgotten goiter is the consequence of the incomplete removal of a plunging goiter. Although in some cases, it may be attributed to a concomitant, unrecognized mediastinal goiter which is not connected to the thyroid with a thin fibrous band or vessels. Absence of signs like mediastinal mass or tracheal deviation in preoperative chest X-ray do not excluded the substernal goiter. CONCLUSION Retrosternal goiter should be suspected if the lower poles could not be palpated on physical examination and when postoperative TSH levels remained unchanged.
ISSN:2210-2612
2210-2612
DOI:10.1016/j.ijscr.2012.11.014