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Abstract
Introduction : Neglected endothoracic goiter is an endothoracic mediastinal portion that was neglected during the surgical removal of a plunging cervical goiter in contrast to autonomous ectopic mediastinal goiter which has its own mediastinal vascularization without connection between the two components and but who was not diagnosed during the cervical thyroidectomy. The aim of this work is to report the point of view of thoracic surgeon to avoid "forgetting" this endothoracic component.Materiel and methods : This is a retrospective study involving four patients, all operated for an endothoracic goiter only by thoracotomy.Results : Among four patients, it was 3 women and one men with an average age of 46 years. All Four cases have already been operated for cervical goiter by cervicotomy alone. Also, for all patients, the discovery was accidental. the cervicothoracic scan found a posterior mediastinal heterogeneous mass, with calcification lesions in 2 patients, and necrosis zone in 2 patients. The four patients were operated by posterolateral thoracotomy. Operative outcome was simple in all patients except 2 cases of wound infection.Conclusion : Neglected endothoracic goiter poses a diagnostic and also a therapeutic problem because its a difficult surgery due to the adhesions already formed following a first cervical thyroid surgery and therefore it is essential not to miss the diagnosis of any diving goiter.
Highlights
Neglected endothoracic goiter is an endothoracic mediastinal portion that was neglected during the surgical removal of a plunging cervical goiter in contrast to autonomous ectopic mediastinal goiter which has its own mediastinal vascularization without connection between the two components and but who was not diagnosed during the cervical thyroidectomy
All the authors have actively participated in the redaction, the revision of the manuscript and provided approval for this final revised version
PATIENT CONSENT Written informed consent was obtained from the patient for publication of this case report and any accompanying images
Summary
Le goitre est une hypertrophie localisée ou généralisée de la glande thyroïde. l est généralement purement cervical mais peut avoir un développement intrathoracique. [2,3] Nous avons mené cette étude pour analyser les particularités cliniques, paracliniques et opératoires des goitres endothoraciques négligés et ainsi rapporter le point de vue du chirurgien thoracique afin éviter « l’oubli » de cette composante endothoracique. Les suites post opératoires étaient simples dans tous les cas mis à part une infection de paroi chez deux patients. MATERIELS ET METHODES C’est une étude rétrospective collectant les données cliniques, paracliniques et opératoires de 4 patients, tous opérés dans le service de chirurgie thoracique au CHU Hassan II FES pour un goitre endothoracique négligé. Tous les patients avaient bénéficié d’une TDM cervicothoracique injectée qui avait objectivé une masse hétérogène du médiastin postérieur avec des lésions de calcification chez 2 patients et une zone de nécrose chez 2 patients (figure 2). Droit Masse hétérogène avec des calcifications thoracotomie Infection de la paroi
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