Forgotten goiter: our experience

Forgotten goiter is a rare disease that is defined as a mediastinal thyroid mass after total thyroidectomy. Massard, a French school author, was the first to us this term. According to literature the incidence is between 2-16%. The authors recorded their experience about four cases. Patients age is 46-56 years and three of them were female: case n. 1 was an incidental finding, case n. 2 had cervicobrachialgia, case n. 3 had persistent hyperthyroidism and case n. 4 had thyroid cancer metastases in laterocervical nodes. The time gap between thyroidectomy and reintervention was average 10 years. Diameter of masses is between 8-10 cm. Cervicotomy was enough to carry out in one case, cervicotomy and sternotomy were used in two patients. In one case it was necessary to carry out a cervicosternotomy and right posterolateral thoracotomy because the mass reached the Barety loggia and paraesofageal area. We used new devices for hemostasis and intraoperative nerve monitoring. Cases of permanent hypoparathyroidism, permanent recurrent laryngeal nerve paralysis or hemorrhage were not recognized. The surgery is mandatory after diagnosis. The choice of the type surgery way is conditioned by the relationships that the pathological tissue has with the mediastinal structures and exact location in that area. Surgical management for forgotten goiter in specialized centers is associated with low morbility.