A recurrent intrathoracic goiter and a case of intrathoracic goiter with tracheal narrowing are presented. The symptoms were mainly dyspnea and wheezing, but vascular compression is also a possible severe symptom. The importance of preoperative evaluation regarding the relation of the gland with the surrounding structures such as major vessels and trachea is emphasized. Although ultrasonography is the first step radiologic tool for cervical thyroid pathologies, non-contrast computerized tomography is the preferred method of radiologic evaluation. Valuable information about the extent of gland to the mediastinum and the compressive effect of the gland to the surrounding structures can be evaluated, and operative management can be planned in detail. Intubation of the patient with a tracheal stricture needs to be focused on. The alternatives are discussed on the case with low situated tracheal compression. Most of the intrathoracic goiters can be removed through a cervical incision. Hourglass-shaped goiters or intrathoracic goiters placed in the posterior mediastinum and malignant cases with possible invasions sometimes require a sternotomy or thoracotomy to remove the gland safely thorough vascular structures.
KeywordsGoiter Substernal Surgery Diagnosis Management Sternotomy Complications