[Plunging and intrathoracic goiters].

The authors report 21 cases of cervico-substernal and 9 cases of mediastino-cervical goiters. On the base of their experience they remark that the diagnosis of topographic mediastinal extent of goiter has never been a problem in the mean time that it remains difficult to recognize the possible tumoral nature of the lesion, also utilizing both thyroid angiography and superior caval phlebography. Removal of 27 of 30 goiters was effecuted by cervical approach alone. In two cases a thoraco-lateral approach was added to remove endothoracic neoplastic goiters and in the last case a partial sternotomy was necessary. The authors conclude that the occasional use of sternotomy is not the result of an aprioristic decision, but the consequence of a correct removal obtained through the cervicotomic approach, also for large mediastino-cervical goiters.