The thyroid gland is normally located at the front of the neck. A retrosternal thyroid is when all or part of the thyroid gland is abnormally located below the breastbone (sternum).
Goiters have become less common in the U.S. over the past three decades. This decrease is mostly due to more iodide in the diet. However, although there are fewer goiters, retrosternal goiters are still a possibility in patients who have a growth in their neck.
Most retrosternal goiters have no symptoms for many years. Most are found on routine chest x-rays. When symptoms do occur, they are usually due to pressure on nearby structures, such as the trachea and esophagus.
Cancer is always a concern when a patient has a large growth in the neck. However, unlike with other growths, fine needle aspiration is not recommended to diagnose retrosternal goiters.
Surgery to remove the growth is recommended, even if the patient has no symptoms.
Substernal thyroid; Mediastinal goiter
Updated by: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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