Mediastinal thyroid goiter

What is mediastinal thyroid goiter?

Mediastinal thyroid goiter is an encapsulated, lobulated heterogeneous enlargement of part or all of the thyroid gland, most commonly in asymptomatic women with a palpable cervical goiter. Occasionally, local compressive symptoms are present; 20% of lesions extend inferiorly into the thorax, usually into the left anterosuperior mediastinum, and less commonly into the middle or posterior mediastinal compartment. On imaging, a well-defined, lobulated heterogeneous lesion, often in the anterosuperior mediastinum, with areas of cystic, hemorrhagic, or calcific change is seen, often with tracheal displacement in the neck. Tracheal displacement on a chest radiograph indicates a mass of thyroid origin or a goiter. On CT and MRI, identification of contiguity of the mass with the thyroid gland establishes a thyroid origin. Surgical resection is the treatment of choice for symptomatic lesions, although most patients with a goiter are asymptomatic and require no therapy other than iodine or hormonal replacement.