Saleh Nasr Abu-Daff*, Husameldin Suliman Hussein, Bushra Hafez, Imran Amin Shah and Mohammed Ahmed Abbas
Introduction: Giant Mediastinal Ectopic Thyroid Tissue (GMETT) is a rare entity that presents a diagnostic and therapeutic challenge for clinicians investigating mediastinal masses. Most cases discovered are asymptomatic and incidentally detected on imaging, if symptomatic, symptoms depend on the location and size of the mass. We present a case of a right hemithoracic benign follicular goiter in an asymptomatic patient that was removed through a right posterolateral thoracotomy.
Case presentation: A 39-year-old male is discovered to have an incidental mediastinal mass on a chest radiograph following a road traffic accident. Chest CT scan revealed a heterogeneously enhancing hyper-vascular mediastinal mass in the right paratracheal location with areas of cystic degeneration and calcification. His thyroid gland was normally located in the neck and was not anatomically a part of the mediastinal mass. A CT-guided biopsy of the mass was positive for thyroglobulin and thyroid transcription factor. Thyroid-Stimulating Hormone (TSH) and free Thyroxine (T4) were within normal limits. A right posterolateral thoracotomy was performed during the procedure, the mass was found to be adherent to the lung parenchyma, posterior mediastinal pleura, right main bronchus, and superior vena cava. A complete surgical excision of the mass was achieved, and the patient underwent an uneventful recovery. The lesion was an encapsulated multinodular 15 × 12 × 9 cm round dark red soft tissue with mass firm consistency. Histopathology exhibited thyroid tissue with nodular hyperplasia and cystic changes.
Conclusions: GM-ETT necessitates surgical excision for both diagnostic and therapeutic reasons. The preoperative assessment of GM-ETT location and size aids in directing surgical approach for mass excision.
Published Date: 2025-02-28; Received Date: 2024-12-30
