Surgical management of intrathoracic goiter.

Thirty-three consecutive patients of intrathoracic goiters underwent resection at the TCVGH during a nine-year period 1982-1991. The mean age of 21 men and 12 women was 65 years. Six (18 per cent) had undergone prior thyroid surgery. Thirty-one of the 33 patients were euthyroid. Thirty patients underwent transcervical approach for resection; three had cervical incision plus median sternotomy. Pathological examination revealed multinodular goiter in 31 (94 per cent) and follicular carcinoma in two (6 per cent). The mean mass of goiter was 201.25 g and the mean greatest dimension was 10 cm. Thyroidectomy is advisable in all cases of intrathoracic goiter and resection can almost invariably be performed through a transcervical approach.