Substernal Goiter

An enlarged THYROID GLAND with at least 50% of the gland situated behind the STERNUM. It is an unusual presentation of an intrathoracic goiter. Substernal goiters frequently cause compression on the TRACHEA leading to deviation, narrowing, and respiratory symptoms.

Also Known As:

Networked: 88 relevant articles (2 outcomes, 5 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hemorrhage
2.	Esophageal and Gastric Varices (Esophageal Varices)
3.	Goiter
4.	Neoplasms (Cancer)
5.	Substernal Goiter

Experts

1.	Hegedüs, Laszlo: 3 articles (12/2010 - 04/2002)
2.	Bonnema, Steen J: 3 articles (12/2010 - 04/2002)
3.	Ríos, Antonio: 3 articles (05/2010 - 02/2006)
4.	Parrilla, Pascual: 3 articles (05/2010 - 02/2006)
5.	Tatti, Alberto: 2 articles (11/2012 - 07/2005)
6.	Calò, Pietro Giorgio: 2 articles (11/2012 - 07/2005)
7.	Nicolosi, Angelo: 2 articles (11/2012 - 07/2005)
8.	Katlic, Mark R: 2 articles (01/2011 - 01/2011)
9.	Randolph, Gregory W: 2 articles (01/2011 - 01/2011)
10.	Grillo, Hermes C: 2 articles (01/2011 - 01/2011)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Substernal Goiter:

1.	IodoproteinsIBA 02/01/1969 - "Intrathoracic goiter in a euthyroid patient: localization with 125-I and study of thyroidal iodoproteins."
2.	Glucose (Dextrose)FDA LinkGeneric 03/01/2012 - "Usefulness of a whole-body (18)F-fluorine-2-fluoro-D: -glucose positron emission tomography/computed tomography study and intraoperative fine-needle aspiration cytology in the management of primary intrathoracic goiters is discussed."
3.	FluorineIBA 03/01/2012 - "Usefulness of a whole-body (18)F-fluorine-2-fluoro-D: -glucose positron emission tomography/computed tomography study and intraoperative fine-needle aspiration cytology in the management of primary intrathoracic goiters is discussed."
4.	BariumIBA 07/01/1989 - "The diagnosis of substernal goiter was made on clinical examination augmented by such radiologic studies, as chest x-ray, barium esophagograms, airway films, and CT scans. "
5.	Sodium Pertechnetate Tc 99m (Pertechnetate)FDA Link 11/01/2012 - "Primary intrathoracic goiter: Incidental diagnosis on 99m-Tc pertechnetate radioisotope thyroid scan." 11/01/1996 - "Tc-99m pertechnetate imaging and CT show bilateral huge cervical and intrathoracic goiter extending to the posterior mediastinum." 09/01/1986 - "The toxic intrathoracic goiter demonstrated avid uptake of [131I] and [99mTc]pertechnetate, with comparatively faint isotopic accumulation seen in the cervical thyroid. " 09/01/1983 - "In five patients with substernal goiter, three of whom presented with superior vena cava (SVC) syndrome, and in five normal subjects, radionuclide superior cavography (RNSC) was performed with extension and flexion of the neck during tracer administration (simultaneous bilateral injection of Tc-99m pertechnetate). " 04/01/1982 - "A case is reported to Tc-99m pertechnetate accumulation within an anterior mediastinal thymoma during a search for substernal goiter. "
6.	IodineIBA 12/01/1988 - "If the iodine scintigram shows accumulation in the tumor, we can be practically sure of the diagnosis of an intrathoracic goiter. " 12/01/2010 - "Although levothyroxine is not recommended for goiter shrinkage, there is increasing focus on radioactive iodine as an alternative to surgery in secondary intrathoracic goiters. "
7.	CosmeticsIBA 01/01/2008 - "The simple nodular goiter, the etiology of which is multifactorial, encompasses the spectrum from the incidental asymptomatic small solitary nodule to the large intrathoracic goiter, causing pressure symptoms as well as cosmetic complaints. " 02/01/2003 - "The simple nodular goiter, the etiology of which is multifactorial, encompasses the spectrum from the incidental asymptomatic small solitary nodule to the large intrathoracic goiter, causing pressure symptoms as well as cosmetic complaints. "
8.	Thyroid-Stimulating ImmunoglobulinsIBA 01/01/1993 - "Radioiodine-131 therapy failed to give sufficient effect, and the intrathoracic goiter became enlarged in association with increases in thyroid stimulating antibody activities, followed by the development of SVC syndrome. "
9.	HLA-C Antigens (HLA-C)IBA 02/01/2006 - "The analyzed variables included age, sex, family history of thyroid pathological abnormalities, clinical features of the patient, clinical grading of the goiter, intrathoracic thyroid component, goiter weight, associated carcinoma, and the HLA-C gene. "
10.	Thyroxine (Levothyroxine)FDA LinkGeneric 12/01/2010 - "In primary as well as secondary intrathoracic goiter, the therapy of choice is total/near-total thyroidectomy and subsequent levothyroxine substitution. " 12/01/2010 - "Although levothyroxine is not recommended for goiter shrinkage, there is increasing focus on radioactive iodine as an alternative to surgery in secondary intrathoracic goiters. "

Therapies and Procedures

1.	Thyroidectomy 08/01/2015 - "Prospective non-randomised study of 242 consecutive patients with substernal goiter out of 2258 patients (11%) who underwent thyroidectomy. " 08/01/2015 - "The objective of this study was to evaluate the use of harmonic scalpel (FOCUS shear, Ethicon Endo-Surgery) in thyroidectomy for substernal goiter for blood loss, operative time, hospital stay and complications. " 07/01/2014 - "Between 2005 and 2012, 665 patients were referred to our clinic for thyroidectomy, 42 patients (6.3%) had substernal goiter and were included in this study. " 08/01/2015 - "Harmonic scalpel is a safe tool for thyroidectomy for substernal goiter. " 08/01/2015 - "No previous prospective study has evaluated harmonic scalpel in thyroidectomy for substernal goiter. "
2.	Sternotomy 05/01/2010 - "To analyze the results of surgery for toxic intrathoracic goiter in terms of (a) the need for sternotomy; (b) morbidity and mortality; and (c) remission of compressive symptoms. " 07/01/2014 - "The aim of this study was to identify the preoperative predictors of a sternotomy in the management of substernal goiter in order to provide better preoperative planning and patient consent. " 11/01/2015 - "Substernal goiter: when is a sternotomy required?" 04/01/2015 - "Surgical treatment of substernal goiter occasionally involves sternotomy. " 04/01/2015 - "Sternotomy for substernal goiter: retrospective study of 52 operations."
3.	Thoracotomy 09/01/2006 - "This patient having a primary intrathoracic goiter presented with posterior mediastinal mass that was removed through a right lateral thoracotomy." 07/01/2001 - "Electromyographic nerve identification during resection of an intrathoracic goiter via a right anterolateral thoracotomy using a novel method." 07/01/2014 - "Surgical approach of substernal goiter can most commonly be performed using the cervical access, but at times, a sternotomy or thoracotomy is necessary. " 07/01/2008 - "Issue 2. Prospective level V data suggest that, for most patients, expert endocrine surgeons utilize an extracervical approach approximately 2% of the time to remove a substernal goiter safely; a sternotomy or thoracotomy appears more likely in cases of a primary substernal goiter or a mass larger than the thoracic inlet (no recommendation). " 03/01/2002 - "A median sternotomy and thoracotomy were performed in one patient each for a primary intrathoracic goiter. "
4.	Catheters 10/01/1998 - "Use of a Foley catheter in the removal of a substernal goiter." 02/01/1998 - "We describe a method whereby a Foley catheter is used to deliver a large substernal goiter through a cervical incision. " 02/01/1998 - "Use of a Foley catheter in the removal of a substernal goiter."
5.	Neck Dissection (Radical Neck Dissection) 12/01/1995 - "Inpatients included those undergoing thyroid lobectomy (15), total thyroidectomy (8), total thyroidectomy with neck dissection (4), removal of substernal goiter (2), and parathyroidectomy (10). " 09/01/1995 - "Reasons for exclusion included presence of a large dead space, substernal goiter, extensive neck dissection for malignant neoplasm, and large goiters. "