What is Retrosternal Thyroid Goiter? 

A retrosternal thyroid goiter refers to the enlargement of the thyroid gland that extends into the space in the chest between the lungs.  

While the thyroid gland typically resides in the front of the neck, below the Adam’s apple, instances of thyroid enlargement can lead to its extension downward into the chest cavity behind the breastbone. 

What are the Types of Retrosternal Thyroid Goiter? 

There are several retrosternal goiter type based on the sizes: 

• Simple (diffuse) goiter: When the entire thyroid gland is enlarged and extends into the mediastinum. 
• Nodular goiter: When a nodule or lump develops within the thyroid gland. 

• Multinodular goiter: When multiple nodules develop within the thyroid gland. 

Goiters can be categorized based on hormonal levels: 

• Toxic goiter: When the thyroid gland is enlarged and the thyroid overproduces thyroid hormones due to hyperthyroidism. 
• Nontoxic goiter: When the thyroid gland is enlarged, but the thyroid hormone levels are within the normal range 

What are Retrosternal Thyroid Symptoms? 

Retrosternal thyroid symptoms can vary depending on the size of the goiter and how much it compresses nearby structures in the chest. Common retrosternal goiters symptoms may include: 

• Visible swelling or enlargement of the neck 
• Difficulty swallowing 
• Difficulty breathing 
• Hoarseness  
• Voice changes 
• Neck or chest discomfort 
• Coughing or choking sensation 
• Visible swelling in the neck 

What are the Causes of Retrosternal Thyroid Goiter? 

Several factors can contribute to the development of retrosternal thyroid goiter, including: 

• Iodine deficiency: In areas with insufficient dietary intake of iodine, the thyroid gland may enlarge as it tries to compensate for the lack of iodine needed to produce thyroid hormones. 
• Autoimmune thyroid disorders: Conditions such as hypothyroidism or hyperthyroidism can cause inflammation of the thyroid gland and lead to its enlargement. 
• Thyroid cancer: Although less common, thyroid cancer can result in the development of a goiter, including a retrosternal goiter, if the cancerous tissue extends into the mediastinum. 
• Other causes: These include smoking, hormonal changes due to pregnancy, puberty or menopause, and inflammation in the thyroid gland. 

Understanding the underlying retrosternal goiter causes is essential for determining the most appropriate treatment approach. 

How is Retrosternal Thyroid Goiter Diagnosed? 

Dr Taj Chowdhry, a consultant thoracic surgeon in Abu Dhabi, will use the following tests include: 

• Physical examination in which Dr Taj will pay particular attention to the neck and chest area to assess for signs of thyroid enlargement or compression of nearby structures. 
• Imaging tests like ultrasound, CT, and MRI scans are used to assess the gland and size of the goiter. 
• Blood tests are conducted to measure thyroid hormone levels, including thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3). 
• Fine-Needle Aspiration (FNA) Biopsy involves using a thin needle to extract cells from the nodules, which are then examined under a microscope to determine if they are benign or malignant. 
• Radioactive iodine scan for a detailed picture of the gland after administering an injection of radioactive iodine. 

The combination of these diagnostic tests will allow Dr Taj to diagnose retrosternal thyroid goiter accurately, determine its underlying cause, assess its impact on adjacent structures, and develop an appropriate treatment plan. 

How is Retrosternal Thyroid Goiter Treated? 

The treatment of retrosternal thyroid goiter depends on several factors, including the size of the goiter, the presence of symptoms, the underlying cause, and the individual’s overall health. Here are some common treatment options: 

• Medication: If the retrosternal goiter is associated with hyperthyroidism (overactive thyroid), medications such as antithyroid drugs may be prescribed to reduce production of thyroid hormone and alleviate symptoms. 

• Radioactive Iodine Therapy: This treatment involves the oral administration of radioactive iodine, which selectively destroys thyroid tissue. It is often used to shrink the size of the goiter and reduce thyroid hormone production, especially in cases of hyperthyroidism or toxic nodular goiter. 

• Thyroid Hormone Replacement Therapy: For hypothyroidism (underactive thyroid) caused by the goiter, thyroid hormone replacement medication may be prescribed to restore hormone levels and alleviate symptoms. 

• Retrosternal Thyroid Surgery: Surgical removal of a portion or all of the thyroid gland may be recommended in cases where the retrosternal goiter is causing significant symptoms, such as difficulty breathing, swallowing, or persistent compression of adjacent structures. Thyroidectomy may be considered as a retrosternal goiter surgical approach if there are concerns about thyroid cancer or if other treatment options are ineffective or not feasible. 

Consult Dr Taj Chowdhry for Thyroid Retrosternal Goiter Treatment in Abu Dhabi 

Understanding retrosternal thyroid goiter and its causes is essential for effective management. From iodine deficiency to thyroid cancer, various factors can contribute to its development.  

Consulting with a highly skilled Consultant Thoracic Surgeon in Abu Dhabi, such as Dr Taj Chowdhry, is essential for precise diagnosis and tailored treatment. Dr Taj brings over 15 years of valuable clinical experience and expertise in thoracic surgery, offering comprehensive and compassionate care to patients with retrosternal thyroid goiter.