{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:55:35Z","timestamp":1777312535604,"version":"3.51.4"},"reference-count":74,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,4]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    The retrosternal goiter (RSG) is a slow-growing mass often benign in nature; thyroidectomy remains the preferred standard curative treatment. This study aimed to explore the local experience of RSG with respect to the clinical presentation, classifications, management, and outcomes.\n                    <jats:bold>Method:<\/jats:bold>\n                    A retrospective chart review was conducted to include all cases diagnosed with RSG and underwent thyroidectomy between January 1998 and December 2013.\n                    <jats:bold>Results:<\/jats:bold>\n                    A total of 1210 patients underwent thyroidectomy; of which 30 (2.5%) patients were diagnosed to have RSG. The commonly reported symptoms were dyspnea (40%), pain and discomfort (30%), dysphagia (26.7%), and hoarseness (20%). Thirteen patients (43.3%) were completely asymptomatic. The fine-needle aspiration cytology was performed in 22 (73.3%) patients, of whom the majority was benign (77.3%). The grading classification showed that grade 1 is the most frequent (73.3%). Total bilateral thyroidectomy was the most prevailing procedure in 57% cases followed by partial thyroidectomy. All patients underwent retrosternal thyroidectomy through a cervical incision except for one case. Postoperative histopathology showed frequent benign multinodular goiter (83.3%), followed by papillary thyroid cancer (10%) and thyroiditis (6.7%). The most common complication after thyroidectomy was tracheomalacia (13.4%), transient hypocalcemia (10%), and hypoparathyroidism (6.7%). There was no intraoperative or perioperative mortality.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    RSG is a rare entity often presented with pressure symptoms, mostly involving anterior mediastinum and had a challenging surgical procedure. A large multicenter study is needed to include more cases in order to have a consensus on the definition and classification system for such important clinical goiter presentation.\n                  <\/jats:p>","DOI":"10.5339\/qmj.2020.13","type":"journal-article","created":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T01:30:59Z","timestamp":1594776659000},"source":"Crossref","is-referenced-by-count":11,"title":["Clinical Presentation and Surgical Treatment of Retrosternal Goiter: A Case Series Study"],"prefix":"10.5339","volume":"2020","author":[{"given":"Husham","family":"Abdelrahman","sequence":"first","affiliation":[{"name":"Trauma Surgery Section, Hamad General Hospital (HGH), Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Al-Thani","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hamad General Hospital (HGH), Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Al-Sulaiti","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hamad General Hospital (HGH), Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelhakem","family":"Tabeb","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hamad General Hospital (HGH), Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayman","family":"El-Menyar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"key":"CIT0001","series-title":"Report of a case and review of sternotomy indications. Int J Surg Case Rep.","first-page":"35","article-title":"Patient-tailored management of an asymptomatic massive substernal goiter presenting as brachiocephalic vein occlusion","volume":"31","author":"Sahsamanis\n\u00a0\nG","year":"2017"},{"issue":"6","key":"CIT0002","series-title":"Acta Otorhinolaryngol Ital.","first-page":"331","article-title":"Surgical approach to retrosternal goitre: do we still need sternotomy?","volume":"29","author":"Rugiu\n\u00a0\nMG","year":"2009"},{"key":"CIT0003","unstructured":"Di Crescenzo V, Vitale M, Valvano L, Napolitano F, Vatrella A, Zeppa P, et al. Surgical management of cervico-mediastinal goiters: our experience and review of the literature. 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Correlation of symptoms with cross-sectional imaging findings","volume":"121","author":"Mackle\n\u00a0\nT","year":"2007"},{"issue":"4","key":"CIT0007","series-title":"Eur Rev Med Pharmacol Sci.","first-page":"265","article-title":"Surgical treatment of retrosternal goiter","volume":"11","author":"Batori\n\u00a0\nM","year":"2007"},{"issue":"2","key":"CIT0008","series-title":"Am J Surg.","first-page":"283","article-title":"Substernal goiter Analysis of 80 patients from Massachusetts General Hospital","volume":"149","author":"Katlic\n\u00a0\nMR","year":"1985"},{"issue":"6","key":"CIT0009","series-title":"J Otolaryngol.","first-page":"393e6","article-title":"Retrosternal goiter","volume":"12","author":"deSouza\n\u00a0\nFM","year":"1983"},{"key":"CIT0010","series-title":"Ann Endocrinol (Paris)","first-page":"230","article-title":"Les goitres plongeants: 218 cas ope're's","volume":"53","author":"Cougard\n\u00a0\nP","year":"1992"},{"issue":"4","key":"CIT0011","series-title":"Eur J Cardiothorac Surg.","first-page":"393e7","article-title":"Surgical aspects of 175 mediastinal goiters","volume":"14","author":"Vadasz\n\u00a0\nP","year":"1998"},{"issue":"5","key":"CIT0012","series-title":"Arch Surg.","first-page":"609","article-title":"Mediastinal goiters. 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Int J Surg. 2018;60:279\u2013282\n."},{"issue":"1","key":"CIT0016","series-title":"Int J Surg.","first-page":"71","article-title":"A new classification system for retrosternal goitre based on a systematic review of its complications and management","volume":"6","author":"Huins\n\u00a0\nCT","year":"2008"},{"key":"CIT0017","unstructured":"Randolph GW, Rameau A, Netterville JL. Chapter 7: Surgery of cervical and substernal. In Surgery of the Thyroid and Parathyroid Glands. Second Edition; Boston, MA, USA; 2012\n."},{"issue":"12","key":"CIT0018","series-title":"Int J Surg Case Rep.","first-page":"1064","article-title":"A rare instance of retrosternal goitre presenting with obstructive sleep apnoea in a middle-aged person","volume":"4","author":"Rodrigues\n\u00a0\nJ","year":"2013"},{"issue":"4","key":"CIT0019","series-title":"Int Surg.","first-page":"419","article-title":"Substernal goiter: when is a sternotomy required?","volume":"99","author":"Coskun\n\u00a0\nA","year":"2014"},{"issue":"1","key":"CIT0020","series-title":"Eur Ann Otorhinolaryngol Head Neck Dis.","first-page":"19","article-title":"Substernal goiter: experience with 50 cases","volume":"133","author":"Benbakh\n\u00a0\nM","year":"2016"},{"issue":"1","key":"CIT0021","series-title":"Nigeria. 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Thyroid Cancer (Version 3.2018). Available from: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/thyroid.pdf. Accessed March 3, 2019\n."},{"issue":"9","key":"CIT0030","series-title":"Surg Today.","first-page":"732","article-title":"Surgical management of substernal goiters: clinical experience of 170 cases","volume":"34","author":"Erbil\n\u00a0\nY","year":"2004"},{"issue":"4","key":"CIT0031","series-title":"Eur Arch Otorhinolaryngol.","first-page":"217","article-title":"Multinodular goiter: surgical management and histopathological findings","volume":"259","author":"Prades\n\u00a0\nJM","year":"2002"},{"issue":"2","key":"CIT0032","series-title":"A prospective single-centre study. 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The need for an aggressive approach","volume":"127","author":"Sanders\n\u00a0\nLE","year":"1992"},{"issue":"2","key":"CIT0013","series-title":"Ann Thorac Med.","first-page":"57","article-title":"Surgical management of retrosternal goiter: Local experience at a university hospital","volume":"7","author":"Khairy\n\u00a0\nGA","year":"2012"},{"key":"CIT0014","series-title":"Int J Surg.","first-page":"S42","article-title":"Surgical approach to mediastinal goiter: an update based on a retrospective cohort study","volume":"28","author":"Polistena\n\u00a0\nA","year":"2016"},{"key":"CIT0015","unstructured":"Agha RA, Borrelli MR, Farwana R, Koshy K, Fowler A, Orgill DP, et al. The PROCESS 2018 Statement: Updating consensus preferred reporting of case series in surgery (PROCESS) guidelines. Int J Surg. 2018;60:279\u2013282\n."},{"issue":"1","key":"CIT0016","series-title":"Int J Surg.","first-page":"71","article-title":"A new classification system for retrosternal goitre based on a systematic review of its complications and management","volume":"6","author":"Huins\n\u00a0\nCT","year":"2008"},{"key":"CIT0017","unstructured":"Randolph GW, Rameau A, Netterville JL. Chapter 7: Surgery of cervical and substernal. In Surgery of the Thyroid and Parathyroid Glands. Second Edition; Boston, MA, USA; 2012\n."},{"issue":"12","key":"CIT0018","series-title":"Int J Surg Case Rep.","first-page":"1064","article-title":"A rare instance of retrosternal goitre presenting with obstructive sleep apnoea in a middle-aged person","volume":"4","author":"Rodrigues\n\u00a0\nJ","year":"2013"},{"issue":"4","key":"CIT0019","series-title":"Int Surg.","first-page":"419","article-title":"Substernal goiter: when is a sternotomy required?","volume":"99","author":"Coskun\n\u00a0\nA","year":"2014"},{"issue":"1","key":"CIT0020","series-title":"Eur Ann Otorhinolaryngol Head Neck Dis.","first-page":"19","article-title":"Substernal goiter: experience with 50 cases","volume":"133","author":"Benbakh\n\u00a0\nM","year":"2016"},{"issue":"1","key":"CIT0021","series-title":"Nigeria. J West Afr Coll Surg.","first-page":"31","article-title":"Experience with managing retrosternal goiters in Ibadan","volume":"6","author":"Ayandipo\n\u00a0\nOO","year":"2016"},{"issue":"2","key":"CIT0022","series-title":"Int Surg.","first-page":"61","article-title":"Nacchiero Miniello S, Lanora AS, Piccinni G, Di Venere B. Management of retrosternal goiters: experience of a surgical unit","volume":"90","author":"Testini\n\u00a0\nM","year":"2005"},{"issue":"6","key":"CIT0023","series-title":"Arch Surg.","first-page":"656","article-title":"Predictors of airway complications after thyroidectomy for substernal goiter","volume":"139","author":"Shen\n\u00a0\nWT","year":"2004"},{"issue":"2","key":"CIT0024","series-title":"Isr Med Assoc J.","first-page":"106","article-title":"Retrosternal thyroid goiter: 15 years\u2019 experience","volume":"8","author":"Nun\n\u00a0\nAB","year":"2006"},{"issue":"6","key":"CIT0025","series-title":"Otolaryngol Head Neck Surg.","first-page":"849","article-title":"The surgical approach to retrosternal goiters: the role of computerized tomography","volume":"132","author":"Grainger\n\u00a0\nJ","year":"2005"},{"issue":"5","key":"CIT0026","series-title":"Langenbecks Arch Surg.","first-page":"337","article-title":"Thyroid carcinoma is intrathoracic goiter","volume":"383","author":"Nervi\n\u00a0\nM","year":"1998"},{"issue":"2","key":"CIT0027","series-title":"Oper Techn Otolaryngol Head Neck Surg.","first-page":"118","article-title":"Surgery for substernal goiters","volume":"5","author":"Cohen\n\u00a0\nJP","year":"1994"},{"issue":"6","key":"CIT0028","series-title":"Head Neck.","first-page":"792","article-title":"CT cross-sectional imaging classification system for substernal goiter based on risk factors for an extracervical surgical approach","volume":"33","author":"Mercante\n\u00a0\nG","year":"2011"},{"key":"CIT0029","unstructured":"National Comprehensive Cancer Network. Thyroid Cancer (Version 3.2018). Available from: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/thyroid.pdf. Accessed March 3, 2019\n."},{"issue":"9","key":"CIT0030","series-title":"Surg Today.","first-page":"732","article-title":"Surgical management of substernal goiters: clinical experience of 170 cases","volume":"34","author":"Erbil\n\u00a0\nY","year":"2004"},{"issue":"4","key":"CIT0031","series-title":"Eur Arch Otorhinolaryngol.","first-page":"217","article-title":"Multinodular goiter: surgical management and histopathological findings","volume":"259","author":"Prades\n\u00a0\nJM","year":"2002"},{"issue":"2","key":"CIT0032","series-title":"A prospective single-centre study. 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