Mediastinal goiter: a comprehensive study of 60 consecutive cases with special emphasis on identifying predictors of malignancy and sternotomy

BackgroundWe describe the clinical characteristics of patients with mediastinal goiter and our principles in surgical management of this pathology; we also identify the predictive factors of malignancy, sternotomy, and posterior mediastinal extension.MethodsWe conducted a retrospective chart review of 60 patients with mediastinal goiter who underwent surgical intervention.ResultsMajor perioperative complications were recurrent laryngeal nerve sacrifice (3.3%) and vagus nerve sacrifice (1.7%). A total of 12.7% of cases were malignant. The presence of dysphonia increased the likelihood of malignancy (P = .02), and malignancy was associated with a significant increase in sternotomy (P = .04) and nerve sacrifice (P < .001) during surgery. A history of thyroidectomy was a predictive factor for extension of the tumor to the posterior mediastinum (P = .02).ConclusionsPresenting with dysphonia is a predictor of malignancy that necessitates careful surgical planning because malignancy is associated with an increase in nerve injury and sternotomy during surgery.