Learning Radiology xray montage
 
 
 
 
 

Substernal Thyroid Goiter



• Extension of a thyroid goiter arising in the neck inferiorly into the thorax is relatively uncommon

• Most (75-80%) arise from lower pole or isthmus of the thyroid and extend into anterior mediastinum

• Some arise from posterior aspect of the thyroid and extend into posterior mediastinum, almost always on the right

Usually nodular, colloid goiters

            •Thyrotoxicosis and carcinoma are rare

• Thyroid mass is typically well-encapsulated and may show degeneration (calcification)

Most patients are asymptomatic

Imaging

• Sharply defined, smooth or lobulated soft tissue mass which characteristically displaces the trachea

• They do not usually project below the arch of the aorta differentiating them from thymomas and teratomas

• Those in the posterior mediastinum characteristically interpose between the trachea in front and the esophagus in back

• On CT, they usually contrast enhance and many times are found to contain calcification.

  • Contrast enhancement is usually prolonged.

• Curvilinear calcifications are highly suggestive of a degenerated thyroid adenoma

• Radioisotope scan is diagnostic

 

 

Thyroid goiter, CT,thyroid mass, image


Substernal Thyroid Goiter.
Contrast-enhanced CT of the chest shows a large, contrast-enhancing
mass in the anterior mediastinum containing calcifications and areas of necrosis.
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substernal thyroid


Substernal Thyroid Goiter.
Contrast-enhanced CT of the chest shows a large, contrast-enhancing
mass in the anterior mediastinum (red arrows) displacing the trachea (White arrow) to the right.

 

Substernal Thyroid Goiter


Substernal Thyroid Goiter. Frontal chest radiograph shows a large superior/anterior mediastinal mass (white arrows) displacing the trachea (black arrow) to the right of midline.