Posterior mediastinal goiter.

Because of their tendency to progressively enlarge with compression of adjacent structures, as well as the small chance of malignancy, most intrathoracic goiters should be excised surgically. Most anterior substernal goiters and some ipsilateral posterior mediastinal goiters can be removed safely through a cervical incision. Large posterior mediastinal goiters, contralateral retrotracheal or retroesophageal posterior mediastinal goiters, and isolated mediastinal goiters with no significant cervical connection are best removed through a combined cervical and thoracic approach. The Lahey Clinic experience with three patients with posterior mediastinal goiter is described.