Introduction: Most cases of intrathoracic goiter can be managed by cer
vical incision alone. A thoracic approach may be needed when adhesions
or an anomalous blood supply are present or carcinoma is suspected. P
atients and methods: Only 44 patients out of 5263 operated on for goit
er needed a thoracic incision. A sternotomy was performed in 29 cases
and a thoracotomy in 15; a malignancy was present in 9 cases. Symptoms
, surgical approach, histology, survival and pTN staging of these 9 pa
tients were reviewed and discussed; no perioperative mortality was obs
erved. Discussion: A thoracic approach is more frequently needed for t
reatment of intrathoracic thyroid carcinoma as it offers a greater cha
nce of radical excision and better control of intraoperative bleeding.
Histologically, thyroid carcinoma in intrathoracic goiter is often an
aplastic or rare and has a poor long-term survival rate when compared
to cervical forms.