The plunging goiter : about 43 cases

##plugins.themes.academic_pro.article.sidebar##

Published Dec 13, 2011
Download
pdf
Vol. 89 No. 11 (2011): Issue Nov 2011

##plugins.themes.academic_pro.article.main##

Rim Zainine
Chafik El Aoud
Rim Bachraoui
Najeh Beltaief
Semia Sahtout
Ghazi Besbes

Abstract

Background: The plunging goiter consists in a goiter whose lower limit is not palpable in surgical position.
Aim: To study the epidemiologic characteristics, the circumstances of discovery, the clinical signs, and the management of this disease.
Methods: A retrospective study about 43 cases of plunging goiters operated during a period of 14 years in the ENT department of the hospital The Rabta Tunis.
Results: The average age of our patients was 59.3 years. On physical examination, goiter was palpable in 41 patients (95.3%). The plunging character of the goiter was noted, at echography, in 26 patients. A cervico-thoracic scanner was performed in 41 patients (95.3%). It helped to confirm the plunging goiter in all patients.
These goiters were most frequently pre vascular (73.2%) compared to the innomined venous trunk. The lower limits of the intrathoracic extensions were on the level of the superior vena cava in 4 cases (9.7%), on the level of the left brachio-cephalic venous trunk in 16 cases (39%) and on the level of the aortic arch in 15 cases (36,5%). The cervical incision was sufficient in 39 cases (97.5%) and we used a combined sternotomy in one patient (2.5%).
Conclusion: The plunging goiter is a thyroid tumour cervical originally descended, then developed, in the mediastinum. A good clinical examination and paraclinical can reach a definite diagnosis and to achieve better surgical.

Keywords:

Thyroid, goiter, plunging, scanner

##plugins.themes.academic_pro.article.details##

References

  1. Moron JC, Singer JA, Sardi A. Retrosternal goiter: a six year institutional review. Am Surg 1998;64: 889-93.
  2. Shen WT, Kebebew E, Duh QY, Clark OH. Predictors of airway complications after thyroidectomy for substernal goiter. Arch Surg 2004;138:656-60.
  3. Makeieff M, Marlier F, Khudjadze M, Garrel R, Crampette L, Guerrier B. Les goitres plongeants. A propos de 212 cas. Ann Chir 2000;125:18-25.
  4. Moumen M, Menhane M, Nawfik H, EL Fares F. Les goitres plongeants. A propos de 36 cas. J Chir 1990;127:22-27.
  5. Sethom A, Brahem H, Ouni H et al. Les goitres plongeants. A propos de 15 cas. J TUN ORL 2005;14:21-24.
  6. Charfeddine I, Kharrat K, Chakroun A et al. Les goitres plongeants. J TUN ORL 2003;11:13-15.
  7. Cannoni M, Demard F. Les goitres plongeants. Dans Cannoni M, Demard F : Les nodules thyroidiens, du diagnostic à la chirurgie Paris : Arnette, 1995:118-21.
  8. Mack E. Management of patients with substernal goiters. Surg Clin North Am 1995;75:377-94.
  9. Rodriguez JM, Hernandez Q, Pinero A et al. Substernal goiter: clinical experience of 72 cases. Ann Oto Rhinol Laryngol 1999;108:501-4.
  10. Erbil Y, Bozbora A, Barbaros U, Ozamagan S, Azezli A, Molvalilar S. Surgical management of substernal goiters : clinical experience of 170 cases. Surg Today 2004;34:732-6.
  11. André P, Berginiat N, Doreau P, Triaureau G, Berginiat M. Arrêt ventilatoire par goitre hémorragique compressif. J Eur 1999;3:124-7.
  12. Torchio R, Gulotta C, Perboni A et al. Orthopnea and tidal expiratory flow limitation in patients with euthyroid goiter. Chest 2003;124:133-40.
  13. Gulmez I, Oguzkaya F, Bilgin M, Oymak S, Demir R, Ozesmi M. Posterior mediastinal goiter. Monaldi Arch Chest Dis 1999;54:402-3.
  14. Siragusa G, Gelarda E, Geraci G, Albanese L, Di Pace G. Cervico-mediastinal goiter. Our experience . Minerva Chir 1999;54:225-9.
  15. Ntyonga Pono MP, Nzouba L, Mathias A. Le goitre endothoracique toxique : A propos d'un cas. Médecine d'Afrique Noire 1998;45:592-4.
  16. Shah PJ, Bright T, Singh SS et al. Large retrosternal goiter: A diagnostic and management Dilemma. Heart Lung and Circulation 2006;15: 151-2.
  17. Jennings A. Evaluation of substernal goiters using computed tomography and MR imaging. Endocrinol Metab Clin North Am 2001;30:401-14.
  18. Belardinelli L, Gualdi G, Ceroni L, Guadalascara A, Polettini E, Pappalardo G. Comparison between computed tomography and magnetic resonance data and pathologic findings in substernal goiters. Int Surg 1995;80:65-9.
  19. Uchikov A, Nedev P, Murdzhev K, Paskalev G. Diagnosis and treatment of retrosternal goiter. Khirurgia 2003;59:8-10.
  20. Calo PG, Tatti A, Farris S, Piga G, Malloci A, Nicolosi A. Substernal goiter : personnal experience. Ann Ital Chir 2005;76: 331-5.
  21. Batori M, Chatelou E, Straniero A et al. Substernal goiters. Eur Rev Med Pharmacol Sci 2005;9: 355-9.