164 Mediastinal Goiter

CASE 164

image Clinical Presentation

Elderly woman with respiratory distress and a chronic left neck mass

image Radiologic Findings

Coned-down PA chest radiograph (Fig. 164.1) demonstrates a large, well-defined left-sided mediastinal soft-tissue mass and an associated ipsilateral neck mass. Note marked mass effect on the cervical and intrathoracic portions of the trachea. Contrast-enhanced chest CT (mediastinal window) (Figs. 164.2, 164.3) shows a large, heterogeneously enhancing soft-tissue mass that arises from the left lobe of the thyroid gland (Fig. 164.2) and extends into the mediastinum (Fig. 164.3). Note the large area of central low attenuation surrounded by irregular enhancing soft tissue and significant mass effect on the trachea, esophagus, and mediastinal great vessels.

image Diagnosis

Mediastinal Goiter

image Differential Diagnosis

• Thyroid Carcinoma

• Lymphadenopathy; Lymphoma

• Neurogenic Neoplasm


Fig. 164.1


Fig. 164.2


Fig. 164.3

image Discussion


Mediastinal (intrathoracic, substernal, retrosternal) goiter refers to thyroid tissue within the mediastinum. Mediastinal goiter affects approximately 5% of the world population. The term substernal goiter

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Jan 14, 2016 | Posted by in RESPIRATORY IMAGING | Comments Off on 164 Mediastinal Goiter

Full access? Get Clinical Tree

Get Clinical Tree app for offline access