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Am J Surg. 2012 Apr;203(4):442-7. doi: 10.1016/j.amjsurg.2011.03.010. Epub 2011 Sep 3.

Mediastinal goiter: a comprehensive study of 60 consecutive cases with special emphasis on identifying predictors of malignancy and sternotomy.

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1
Center for Special Minimally Invasive and Robotic Surgery, Stanford University Medical Center, Palo Alto, CA 94304, USA. babakhaj@yahoo.com

Abstract

BACKGROUND:

We describe the clinical characteristics of patients with mediastinal goiter and our principles in surgical management of this pathology; we also identify the predictive factors of malignancy, sternotomy, and posterior mediastinal extension.

METHODS:

We conducted a retrospective chart review of 60 patients with mediastinal goiter who underwent surgical intervention.

RESULTS:

Major perioperative complications were recurrent laryngeal nerve sacrifice (3.3%) and vagus nerve sacrifice (1.7%). A total of 12.7% of cases were malignant. The presence of dysphonia increased the likelihood of malignancy (P = .02), and malignancy was associated with a significant increase in sternotomy (P = .04) and nerve sacrifice (P < .001) during surgery. A history of thyroidectomy was a predictive factor for extension of the tumor to the posterior mediastinum (P = .02).

CONCLUSIONS:

Presenting with dysphonia is a predictor of malignancy that necessitates careful surgical planning because malignancy is associated with an increase in nerve injury and sternotomy during surgery.

PMID:
21890099
DOI:
10.1016/j.amjsurg.2011.03.010
[Indexed for MEDLINE]
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