Complete transthoracic resection of giant posterior mediastinal goiter: A case report and review of the surgical approaches

Intrathoracic goiter (IG) is defined as a goiter that is located partially or totally in the anterior or posterior mediastinum, and its incidence is associated with multinodular goiter; therefore, it is more frequent in areas with endemic iodine deficiency [1–2]. Generally, the incidence of intrathoracic thyroid goiters (ITGs) is approximately 10%–15% of all mediastinal masses, and of these, the majority (75%–95%) are located in the anterior superior mediastinal compartment [3], whereas approximately 10%–15% are located in the posterior mediastinum. Posterior mediastinal goiters (PMGs), either retrotracheal or retroesophageal, are rare, comprising 4% of all mediastinal goiters [4]. They are commonly of neural origin and develop into isolated thyroid tumors within the mediastinum or descend into the retrosternal loose tissue space of the neck, which may cause various compressive symptoms when they reach a certain size. Most anterior mediastinal goiters can be removed by a transcervical approach, but those that extend into posterior mediastinal goiters may require additional extracervical incisions [5]. Case presentation