A 50-year-old man was referred to thoracic surgery clinic with shortness of breath. The patient had no history of smoking. There was no history of trauma. Physical examination was normal. Blood biochemistry and hematocrit were normal. Anteroposterior chest radiograph showed a mediastinal enlargement. Non-contrast computed tomography (CT) imaging of the chest demonstrated a large mass (Fig. 1A–H) in the posterior mediastinum displacing the esophagus to the anterior. The mass originating left thyroid lobe was extending to the level of the carina. CT results were considered pathognomonic for substernal goiter. Surgical treatment was no performed because the patient refused operation.
Substernal goiter uncommonly extends to carina level. Substernal or carinal goiter may cause pericardial effusion or tracheal compression. Severe airway obstruction may rarely require anesthesia.1 CT easily reveals evidences of tracheobronchial tree obstruction.
