Mediastinal goiter: a comprehensive study of 60 consecutive cases with special emphasis on identifying predictors of malignancy and sternotomy

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• 作者：Babak Hajhosseini ; M.D.^a ; ^{babakhaj@yahoo.com} ; Vahid Montazeri ; M.D.^b ; Lachin Hajhosseini ; M.D.^c ; Nariman Nezami ; M.D.^d ; Ramin E. Beygui ; M.D.^e
• 关键词：Intrathoracic goiter ; Mediastinal goiter ; Substernal goiter ; Thyroidectomy ; Sternotomy ; Thyroid
• 刊名：The American Journal of Surgery
• 出版年：2012
• 期刊代码：9_00029610
• 类别：med
• 出版时间：April, 2012
• 卷：203
• 期：4
• 页码：442-447
• 文件大小：200 K

摘要

Background

We describe the clinical characteristics of patients with mediastinal goiter and our principles in surgical management of this pathology; we also identify the predictive factors of malignancy, sternotomy, and posterior mediastinal extension.

Methods

We conducted a retrospective chart review of 60 patients with mediastinal goiter who underwent surgical intervention.

Results

Major perioperative complications were recurrent laryngeal nerve sacrifice (3.3%) and vagus nerve sacrifice (1.7%). A total of 12.7%of cases were malignant. The presence of dysphonia increased the likelihood of malignancy (P = .02), and malignancy was associated with a significant increase in sternotomy (P = .04) and nerve sacrifice (P < .001) during surgery. A history of thyroidectomy was a predictive factor for extension of the tumor to the posterior mediastinum (P = .02).

Conclusions

Presenting with dysphonia is a predictor of malignancy that necessitates careful surgical planning because malignancy is associated with an increase in nerve injury and sternotomy during surgery.