Quick Case: Left Retrosternal Goiter

Case Presentation

Patient Profile
A 44-year-old male arrived for a routine office visit as part of an annual health check-up. His BMI was 26, and he had nothing particular in his history. But, on detailed questioning, he complained of chest pain on the left side of the upper chest and occasional difficulty in swallowing.

Examination

All investigations were normal:

  • Blood counts
  • Thyroid function test
  • RFT
  • ECG, TMT, 2D Echo

An X-ray of the chest showed a deviated trachea on the right side. The patient was subjected to further investigations looking into this.

A CT Scan of the neck and chest was performed, with contrast. The result showed a retrosternal goiter displacing the trachea.

CT scan of chest - Dr V

CT scan of neck - Dr V

Treatment

Consulted a head and neck surgeon, and a total thyroidectomy was done. Frozen section showed benign growth. All parathyroids were preserved. The patient is fine and doing normal activities with thyroid hormone replacement.

Learning Points/Take Home Messages

  • All pain on the left side is not cardiac.
  • Regular annual checkups are important, even if asymptomatic.
  • Preventive health checkups are important, in general.

About The Author

Dr. Vachharajani is an experienced practicing family physician in Ahmedabad, Gujarat, with a special interest in obesity and lifestyle-related disorders. With a genuine passion and enthusiasm for healthcare information technology (HIT), he has championed the cause of using HIT in day-to-day clinical practice. In addition to his, MBBS, he holds a post-graduate certificate in environmental and occupational health (PGDMCH).

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