PMC6915127_01
CT neck soft tissue with contrast showing bilateral thyroid goiter with substernal left thyroid extension (blue arrow), rightward tracheal deviation, and mild narrowing. Labels in picture: T: trachea; Ao: aorta; Cl: clavicle.
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The adjacent trachea showed narrowing and rightward displacement due to the thyroid mass (Figure 1).
Thyroid uptake (I-123) scintigraphy showing elevated radioactive iodine uptake at 4 and 24 hours consistent with hyperthyroidism and a cold defect in the inferior pole of an enlarged left lobe for which thyroid carcinoma cannot be excluded.
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A thyroid uptake (Iodine- (I-) 123) scintigraphy showed a cold defect in the inferior pole of an enlarged left lobe (Figure 2).
(A) The right multinodular thyroid lobe with inferior pole tail-like extension measuring 8 x 4 x 3 cm. Note the tail-like extended protrusion (red arrow). (B) Posterior ectopic thyroid measuring 8 x 5 x 2 cm. Note the teardrop shape resembling a remnant tract on the superior end (green arrow). (C) Substernal ectopic thyroid measuring 6 x 5 x 3.5 cm. (D) Left thyroid lobe measuring 8 x 5 x 2 cm.
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The left thyroid lobe was dissected with difficulty due to its larger left lobar size (10 x 7 x 5 cm), hypervascularity, and multinodularity (Figure 3). All of these masses were safely and completely excised (Figure 3). The right multinodular thyroid lobe measured 8 x 4 x 3 cm in size (Figure 3).
PMC6915127_02
Coronal view of CT neck showing a substernal anterior mediastinal exophytic mass (blue arrow) found to be a benign thyroid mass by US-FNAC measuring 9 x 4 x 3 cm.
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fig4
She was referred after a CT scan was done which showed an incidental finding of a left substernal anterior mediastinal exophytic mass measuring 9 x 4 x 3 cm with rightward tracheal deviation (Figure 4).