Management of intrathoracic goitre.

an intrathoracic goitre is a thyroid gland with more than 50% of its mass located below the thoracic inlet. This term can be further classified as an “incomplete” or a “complete” intrathoracic goitre. When the goitre is “incomplete,” a major portion of the goitre on the neck is visible, with its lower pole being substernal, subclavicular or intrathoracic. Conversely, a “complete” or “true” intrathoracic goitre is one that is completely within the mediastinum and separate from a coexisting cervical thyroid gland. Thus, the uppermost part is barely palpable in the sternal notch. Most intrathoracic goitres can be removed safely through a cervical incision. More invasive sternotomy can be performed for complicated cases in which the goitre cannot be removed by any other procedure.