Wagner Russel T, Khalili Sammy, Mundi Neil S
Intent Medical Group, Department of Neurosciences, Endeavor Health, Northwest Community Hospital, Arlington Heights, IL, USA.
SAGE Open Med Case Rep. 2025 Jul 20;13:2050313X251357398. doi: 10.1177/2050313X251357398. eCollection 2025.
Retropharyngeal goiters are uncommon entities characterized by the presence of thyroid tissue in the retropharyngeal space. We present the case of an 89-year-old female with a history of dysphagia and hoarseness of voice. Imaging revealed a massive goiter extending into the retropharyngeal and retrosternal spaces. The patient underwent a total thyroidectomy with transcervical removal of the substernal component. Our analysis of 13 documented cases (14 including ours) of retropharyngeal multinodular goiters reveals a range of presentations with dysphagia, dysphonia, and dyspnea being the most common symptoms. Total thyroidectomy emerged as the prevailing management approach, though there are surgical challenges including airway management and potential pharyngeal musculature injury. The most plausible mechanism for retropharyngeal goiter development is progressive displacement due to glandular enlargement. This case highlights the clinical considerations and perioperative strategies required for the management of retropharyngeal goiters, particularly in elderly patients with significant anatomic distortion. Additionally, we provide a comparative literature review to further characterize the presentation and surgical management of this rare entity.
咽后甲状腺肿是一种罕见的疾病，其特征是在咽后间隙存在甲状腺组织。我们报告一例89岁女性病例，该患者有吞咽困难和声音嘶哑病史。影像学检查显示一个巨大的甲状腺肿延伸至咽后间隙和胸骨后间隙。患者接受了全甲状腺切除术，并经颈部切除了胸骨后部分。我们对13例（包括我们的病例共14例）记录在案的咽后多结节性甲状腺肿病例的分析显示，其表现多样，吞咽困难、声音嘶哑和呼吸困难是最常见的症状。全甲状腺切除术已成为主要的治疗方法，尽管存在包括气道管理和潜在咽肌损伤在内的手术挑战。咽后甲状腺肿形成的最合理机制是由于腺体增大导致的渐进性移位。该病例突出了咽后甲状腺肿管理所需的临床考虑和围手术期策略，特别是在解剖结构严重扭曲的老年患者中。此外，我们提供了一篇比较文献综述，以进一步描述这种罕见疾病的表现和手术治疗。
