Mediastinal thyroid mass

Seven percent of mediastinal tumors are of thyroidal origin. The incidence of mediastinal/substernal thyroid masses ranges from 2.6% to 21% of patients undergoing thyroidectomy. The wide range in reported incidence is largely due to variation in the definition of substernal thyroid masses. They can be defined as a thyroid gland with cervical extension that descended below the thoracic inlet. The purpose of this report is to discuss an 84-year-old male with shortness of breath, pain radiating to the chest, dysphagia, and odynophagia. The patient was admitted to the hospital for retrosternal chest pain and pneumonia. A computerized axial tomography scan of the chest revealed a mediastinal mass compressing the trachea. The patient underwent neck and mediastinal exploration, with complete excision of the mediastinal thyroid. We were able to deliver the mass into the neck from the mediastinum avoiding the need for sternotomy or thoracotomy.