Intrathoracic Goiter and Thyroid Nodule: Case Report

Introduction: There is a strong correlation between the incidents. of substernal goiter and cervical goiter and endemic in some regions. The incidence of substernal goiter is difficult to evaluate, but between 3 and 21% of these patients undergo thyroidectomy, as was our case. This variation reflects the lack of a definitive definition of substernal goiter. Clinical Case: A 57-year-old female from the outpatient clinic was referred from another hospital center with a history of total thyroidectomy due to goiter and compressive symptoms in 2009, post-surgical hypothyroidism with subsequent management with levothyroxine 100 mcg per day. His current condition began in 2021 with myalgia, low back pain, dyspnea with medium effort and a sensation of retrosternal oppression, so he went to a doctor, where a chest x-ray was performed, finding an intrathoracic tumor, so a fine-needle-guided biopsy was performed. with a report of ectopic thyroid tissue (upper mediastinum) benign category II, for which she was referred to this unit. She persists with low back pain, which increases with physical activity. She denies dysphagia or other additional symptoms. Discussion: Primary intrathoracic goiter is a rare congenital entity that arises from accessory and/or ectopic thyroid tissue originating from an orthotopic thyroid gland and can cause complications such as respiratory obstruction and malignancy. These entities are generally managed surgically due to an increased risk of respiratory complications or malignancy. In contrast, secondary thyroid goiter is a more common entity arising from orthotopic thyroid tissue and its differential diagnosis should be considered when mediastinal masses are incidentally found.