1/7. Schwannoma of the left brachial plexus mimicking a cervicomediastinal goiter in a young Nigerian lady.The schwannoma is thought to arise from the schwann cells of the nerve sheath. This tumor is usually solitary and may arise from any cranial or peripheral nerve. It is encapsulated and appears to arise focally on a nerve trunk so that the nerve itself is stretched over the tumor rather than running through it as in neurofibroma. This report is unusual as the tumor started as a cervical swelling which subsequently grew into the mediastinum simulating a retrosternal goiter. The patient, a 25 year-old female was referred to the University College Hospital, Ibadan, 24 hours after an attempted thyroidectomy at a private hospital. The history was of a painless anterior neck swelling of 4 years duration devoid of symptoms of hyperthyroidism with associated dysphagia and weakness of the left hand. Examination showed an asthenic young woman. Her voice was hoarse but there were no eye signs suggestive of thyrotoxicosis. On the anterior neck was a sutured skin-crease scar over a diffuse anterior neck swelling which one could not get below. The left hand showed wasting of the thenar and hypothenar eminences. Thyroid function test results were within normal limits, indirect laryngoscopy showed a left vocal cord paralysis, packed cell volume was 38%. Her chest x-ray showed a huge left retrosternal and apical soft tissue mass displacing the trachea to the right (figure 1). A fine needle aspiration cytology was reported as a chronic lymphocytic thyroiditis. A presumptive diagnosis of thyroid carcinoma with retrosternal extension was made. At surgery, manipulation of the mass was difficult as the tissue was soft, slimy and ruptured easily. Severe hemorrhage was encountered necessitating a median sternotomy to control the bleeding vessels. Her post-operative period was stormy, however she thereafter made gradual progress to warrant her discharge six weeks post surgery.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/7. Ectopic thyroid.Primary mediastinal ectopic goiters are very rare. We report a case in which an ectopic goiter with blood supply from the thoracic vessels necessitated a transternal approach for removal, resulting in a favorable outcome.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/7. Primary intrathoracic goitre.A right paratracheal mass in a 56-year-old man was found to be a primary intrathoracic goitre. Pathological examination showed nodular hyperplasia with focal lymphocytic thyroiditis. Enlarged mediastinal thyroid tissue may result from extension of a cervical goitre into the chest and is then called secondary or may develop from ectopic thyroid tissue located in the mediastinum and is then called primary. In the latter case blood supply comes from local intrathoracic vessels and no connections with the cervical gland are observed. Differentiation can be made by ultrasonography, CT scanning or radioisotope scanning. Primary goitres are best operated on by way of a thoracotomy as troublesome mediastinal bleeding may occur which is difficult to control from a cervical collar incision.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/7. Retrosternal goiter and chylothorax: case report.We describe a case of chylothorax associated with a retrosternal goiter. Such an association has not been previously reported. The chylothorax was probably caused by compression of the thoracic duct and brachiocephalic vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/7. Intrathoracic goitre: a cause of the superior vena cava syndrome.Benign lesions of the mediastinum rarely produce obstruction of the innominate vessels. Two patients with intrathoracic goitre are described who presented with the superior vena cava syndrome. Venography in each case demonstrated the extent of obstruction and degree of collateral circulation. Early recognition of the association of intrathoracic goitre and superior vena caval obstruction may lead to clinical improvement with surgical treatment.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/7. A case report of substernal goiter.A case of substernal goiter is reported. A 78-year-old female was admitted to our hospital with no symptoms. Chest roentgenography on admission showed that a mass of 3 by 5 cm in size with calcification located in the substernal region. Computed tomography of the chest and aortography revealed that the mass was attached to the trachea, but the connection to the great vessels was not clear. Pathological findings of the incisional biopsy specimen showed thyroid tissue with no evidence of malignancy. Our clinical diagnosis was substernal goiter. Surgery was not carried out in this case, based on the literature. Surgery is indicated in case of malignancy or in cases with severe illness such as respiratory disorder and superior vena cava syndrome.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/7. Partial unilateral phrenic nerve paralysis caused by a large intrathoracic goitre.Intrathoracic goitres may cause a variety of symptoms caused by compression of the trachea, neural structures, blood vessels and the oesophagus. A case history is presented of a patient with a recurrent goitre after subtotal thyroidectomy who displayed partial unilateral phrenic paralysis, which subsided after a second subtotal thyroidectomy. Compression of the phrenic nerve appears to be a very rare manifestation of an intrathoracic goitre and thus far has never been reported.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |