Intrathoracic goiters consist of two types: the primary and secondary type. Primary intrathoracic goiters are very rare. We report here on a case that was resected with using the thoracoscopic assist technique. The transthoracic or transsternal approach is necessary for primary goiters to remove them completely without complications.
Goiter ; Goiter, Substernal ; Mediastinum

Normothyroidic single-nodular goiter is a common disease. Now it can be detected and intervented early so that its prognosis is improving significantly. The effectiveness of preventive therapy for nodular goiter by TST releasing inhibition with levothyroxin was examined in 110 patients. The results showed that levothyroxin therapy to inhibit the release of TST is needed for solid lesions. In younger patients with less than 1cm goiter, the result of treatment is more likely to be maximized, the lesions regress completely and the thyroid functions are normalized. For more than 45-year patients with more than 2-cm goiter, the result of treatment is poor. Use levothyroxin with cautions in over 60-year patients who have cardiovascular diseases and multiple nodular goiter.
Goiter, Nodular ; Prevention & control

OBJECTIVETo investigate the diagnosis and treatments of thyroid goiters invading mediastinum and thoracic cavity.

METHODSSeventy-eight cases of thyroid goiters invading mediastinum and thoracic cavity and undergoing surgery from 1995 to 2005 were reviewed. There were 22 males and 56 females and their age ranged from 45 years to 78 years with a median age of 59 years. According to the classification of intrathoracic thyroid goiters, there were 50 cases in Class I, 20 cases in Class II and 8 cases in Class III. In these patients, 38 cases suffered from dyspnea at degree I and 20 cases at degree II. Of the patients, 71 underwent thyroidectomy through neck approach and 7 underwent thyroidectomy by a combined approach of neck incision plus sternotomy or lateral thoracotomy. Tracheal defects in 4 cases and esophageal defects in 3 cases were repaired. Postoperative residual diseases were found in tracheoesophageal wall (5 cases) and mediastinum (6 cases). Eleven patients received postoperative radiotherapy and 18 underwent (131)I treatment. No case died of operation and no case with wound infection.

RESULTSThe time of follow-up was 60 - 180 months with a median of 110 months. Three patients lost follow-up. Dyspnea in 58 cases were improved after operation. Three of 49 patients with nodular goiters died from cardiocerebrovascular diseases. Of 29 patients with thyroid papillary carcinoma, 2 died from lung metastasis and 3 died from neck relapse. Five-year survival rate was 75.0% in the patients with thyroid cancer.

CONCLUSIONSMost of thyroid goiters invading mediastinum and thoracic cavity can be completely resected via neck approach, but a combined approach of neck incision plus sternotomy or lateral thoracotomy may be used in some cases with malignant goiters to dissect the diseases completely. Postoperative external beam radiotherapy are required for the residual diseases. (131)I may be considered in high-risk differentiated thyroid carcinoma cases.

Aged ; Female ; Goiter, Nodular ; pathology ; Goiter, Substernal ; diagnosis ; pathology ; therapy ; Humans ; Male ; Mediastinal Neoplasms ; diagnosis ; secondary ; therapy ; Middle Aged ; Retrospective Studies ; Thoracic Cavity ; pathology ; Thyroid Neoplasms ; diagnosis ; pathology ; therapy

Goiter, Nodular ; Humans ; Thyroid Neoplasms

Foreign Bodies ; diagnosis ; Goiter ; Goiter, Nodular ; diagnosis ; Humans ; Neck

There is a lot of difficulty in the diagnosis of follicular lesions of the thyroid by fine needle aspiration cytology(FNAC). The main purpose of this report is offering more guidance regarding the cytologic appearance to distinguish follicular neoplasm from nodular goiter and laying stress on the presence of mixed group. The histologic and cytologic findings of 23 follicular neoplasms and 13 nodular (adenomatous) goiters were reviewed. Histologic specimens were classified into the microfollicular(MIF), mixed(MIX), and nodular goiter(NG) groups. The comparison of histologic patterns with histologic diagnosis revealed that all the lesions with predominantly microfollicular, trabecular, or solid pattern were follicular carcinoma and all the lesions with predominantly macrofollicular pattern were nodular goiter. The distinguishing cytologic features for the MIF group were irregular cell arrangement in cell groups(100%, p=0.00001), absence of atrophic follicular cells(100%, p=0.0007), abundant microfollicles(100%, p=0.002), pleomorphic nuclei(100%, p=0.002), not predominant syncytial smear pattern(100%, p=0.002), heterochromatin(100%, p=0.032), absence of macrofollicles(100%, p=0.038), scant colloid(100%, p=0.04), clear background(83%, p=0.00006), and uniform sized follicles(83%, p=0.014). And regular cell arrangement(honeycomb appearance) in cell groups(85%, p=0.0000), atrophic change of follicular cells(69%, p=0.0002), syncytial smear pattern(54%, p=0.006), monomorphic nuclei(85%, p=0.008), and hemorrhagic background(100%, p=0.027) were characteristic features of the NG group. Seventeen out of 36 cases(47%) were the MIX group composed of combined cytologic features of the MIF and NG groups. Therefore the frequent presence of the MIX group is considered to be main cause of the difficultyin the diagnosis of follicular lesions by FNAC. The mixed morphologic feature may support the hypothesis of a biologic "continuum" between nodular goiter and follicular neoplasm of thyroid gland.
Biopsy, Fine-Needle* ; Diagnosis ; Goiter ; Goiter, Nodular* ; Thyroid Gland*

Objective:To investigate the value of retrograde thyroidectomy from top to bottom in the operation of retrosternal thyroid surgery. Methods:Retrospective analysis was performed on the cases of retrosternal goiter excised by our surgeons from January 2017 to June 2022,the technical points, feasibility and advantages of the operation were summarized. Results:A total of 15 cases of retrosternal goiter treated by retrograde thyroidectomy were collected, including 5 cases of type Ⅰ retrosternal goiter and 10 cases of type Ⅱ retrosternal goiter.The postoperative pathology was benign. The surgical time is 40-60 minutes for unilateral retrosternal goiter and 70-90 minutes for bilateral goiter. All patients were discharged normally within 7 days after operation, and no operative complications were observed such as bleeding, hoarseness or hypoparathyroidism. Conclusion:This surgical excision method of thyroid is suitable for the type Ⅰ and type Ⅱ retrosternal goiter surgery, which can avoid the difficulties in exposing and separating the the inferior thyroid behind the sternum in conventional surgical method, speed up the operation and reduced the difficulty of operation, and has certain promotion value in clinic.
Humans ; Thyroidectomy/methods* ; Retrospective Studies ; Goiter, Substernal/pathology* ; Hypoparathyroidism/surgery*

Goiter, Nodular ; diagnosis ; Humans ; Thoracic Wall ; pathology

T3, T4, TSH concentrations in the blood of people without endemic goiter living in the island endemic goiter area (A area) were not changed in comparing with health people in Ha Noi (B area). But T3, TSH concentrations increased and T4 decreased in people with and without goiter in A area to compare with healthy people in B area. These above changes were clear in people with goiter in the A area.
Thyroid Hormones ; Goiter, Endemic ; Thyrotropin

A descriptive surveillance study was carried out at Tien Giang province in 6299 people, 30 clusters has showed that Goitre rate was 24,4% in adult and 12,8% in children with iodine trace in urine 4 mcg/dl. The authors recommended the universal use of iodinized salt.
Thyroid Hormones ; Goiter, Endemic ; Thyrotropin