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Primary mediastinal ectopic goiters are very rare and comprise about 1% of all mediastinal tumors. Enlarged mediastinal thyroid tissue may result from extension of a cervical goiter into the chest and is then called secondary or may develop from ectopic thyroid tissue located in the mediastinum and is then called primary (1). Blood supply of primary mediastinal goiter comes from local intrathoracic vessels. Compressing symptoms, diagnostic uncertainty, and the risk of malignancy support surgical excision. Case report: The patient is a 40-year-old woman with a 6-month history of progressive dyspnea, chest and back pain. Chest x-ray showed the left superior mediastinal mass was compressing the trachea. A computed tomography (CT) scan confirmed a posterior mediastinal (retrotracheal visceral mediastinum) mass with cervical connections. (Fig. 1,2.) Thoracic biopsy was performed and pathology was colloidal goiter. The physical examination revealed no abnormalities but stridor.Hematological and chemistry panels were normal. A left posterolateral thoracotomy was performed. The mass was, behind the arcus aorta, left carotid and subclavian arteries. Although the mass was pushing the trachea through the right hemithorax, there was no invasion. On the other hand, the esophagus was compressed to the right and posterior aspect of the thorax. In addition, there was a 13 cm contact between the columna vertebrales and the mass. Mobilization of the mass encountered no communication with the cervical thyroid, and all blood supply to the mass was intrathoracic. The specimen was solid, and measured 13 × 11× 10 cm. Histological examination was representative of colloidal goiter.

Mediastinal goiter: a rare cause of dyspnea, chest and back pain