Retrosternal Thyroid Tissue Extension after Total Thyroidectomy: A Case Report

Thyroid enlargement, a common disorder, which is more prevalent in hilly regions of Pakistan and can be found in 10-20% of the population living in iodine-deficient areas.Goitres tend to grow slowly and may reach the anterior mediastinum over many years.In most cases, retrosternal goitre is an extension of the cervical portion of the thyroid gland.Patients may remain symptom-free; however, if symptoms arise, they typically consist of respiratory problems.Other symptoms that patients may experience include neck swelling, weight loss, and palpitations, i.e., signs and symptoms related to thyrotoxicosis.The symptoms of thyrotoxicosis also included heat intolerance, excessive sweating, and anxiety.Different causes of thyrotoxicosis included Graves' disease (70%), toxic multinodular goitre (5%), and thyroiditis (20%).Diagnosis of retrosternal goitre includes the evaluation of thyroid function tests, chest computed tomography, and radio-iodine scan.Fine needle aspiration cytology (FNAC) is usually avoided due to the presence of vital structures in the anterior mediastinum.The authors present a case of a male patient who presented with symptoms of weight loss and orthopnoea.CT scan showed retrosternal mass extending up to the aortic arch.The patient was given iodine therapy with a steroid cover.