Internal goiter (plunging goiter, retrosternal goiter)

It occurs when a part of the enlarged goitre extends into the thoracic cavity over the years.  When a goitre enlarges in individuals with short neck, it may grow into the thoracic cavity since it cannot find a place to expand in the neck.

The goiter that reaches the line of the clavicles is also called internal goiter, and the goiter that reaches the middle of the chest is called the internal goiter as well.  It may extend towards the front or back of the thoracic cavity.  Half of the patients do not have any complaints.  Shortness of breath and swallowing difficulty can be seen.  It is observed in chest x-ray that the trachea is shifted to the right or left side.  In some patients, internal goiter may lead to tracheal narrowing.  Cervical and thoracic tomography and MRI are ordered for the patients who are suspected to have internal goiter.  

If the lower lobe of the thyroid gland is not palpated during the examination of a patient with goitre, internal goiter is suspected. Ultrasonography and scintigraphy confirm the diagnosis of internal goiter.  When it is looked carefully at a chest x-ray performed for any other reason, the findings of the internal goitre can be seen.

The treatment of internal goiter is surgery.  The lower part is removed usually through an incision made on the neck.  5% of patients may need their chest to be opened.

      

      

                                                       

Very large internal goitre (the part under the instrument was removed from the thoracic cavity) Are thyroid and goiter the same thing?