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Goiter

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Attended Accident and Emergency. Shortness of breath and chest pain.

Patient Data

Age: 70 years
Gender: Female
x-ray

Large symmetrical anterior mediastinal mass.

The superior aspect of the mass ' fades away ' in keeping with this being a superior mediastinal mass, in particular the thyroid gland.

No significant tracheal displacement,

Case Discussion

Mediastinal masses are classically classified into being anterior, middle or posterior in location. This is hypothetical in that:

  • these mediastinal spaces are anatomical rather than structural
  • many mediastinal masses with involve more than one space

Anterior mediastinal masses are composed largely of the the 4Ts:

  • thyroid gland (most common)
  • thymoma
  • teratoma
  • "terrible" lymphoma

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