Introduction
Retrosternal goiter (RG), also referred to as intrathoracic or retrosternal, or cervico-mediastinal goiter, was first described by Haller in 1794 but it still represents a challenge for inexperienced head and neck and thoracic surgeons, as well as for anesthesiologists1,2. Clinically RGs are usually incidental findings, yet they can present sometimes with life-threatening dyspnea. They pose many issues in terms of airway management: because of tracheal deviation, external compression, and risk of tracheomalacia and cardiovascular collapse, RGs should be managed only in referral centers where expected difficulties can be safely managed. In this regard, an accurate preoperative work-up is mandatory in order to avoid complications and to reduce the need for an extra-cervical approach. The most recent review available on RG dates back to some years ago, and since then the evolution of technology has brought in different innovations, especially in new mini-invasive techniques such as image-guided ablation or robotic-assisted transthoracic surgery3.
The present review aims to critically discuss the published evidence in the last five years on the medical and surgical management of RG, with particular attention to the need for multidisciplinary management of these patients.