References

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Figures
Figure 1 . Surgical algorithm for the management of retrosternal goiters.
Figure 2. (a) Coronal plane CT and (b) sagittal plane CT scan showing retrosternal goiter extending into anterior mediastinum just above the aortic arch. (c) Progressive removal of retrosternal goiter with combination of upwards traction and blunt dissection. (d)Final surgical specimen of the retrosternal goiter.
Figure 3: Axial CT of the neck (a) and the chest (b) showing a large retrosternal goiter with low anterior mediastinal extension. Right pleural effusion and basal collapse of the lung was also noted.(c) Exposure of the anterior mediastinum after a low collar incision, median sternotomy, and application of mediastinum retractor.(d) Final surgical specimen, super-imposed on the patient’s chest to demonstrate the extent of retrosternal extension.
Figure 4 . (a) Right thyroid lobe pedicled on the retrosternal component, extending behind the innominate artery. (b) Complete thyroidectomy specimen. (c) View from the intrathoracic endoscope showing exposure of the posterior mediastinal thyroid lobe after incising the right pleura. (d) View of the mediastinal component of the thyroid gland completely free from the surrounding tissues.