Retrosternal goiter involving the Zuckerkandl tubercle
Incidental finding in an elderly patient having CTPA
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Heterogeneous mass sitting posterior to the trachea and to the right of the esophagus represents a multinodular goiter involving the accessory lobe of Zuckerkandl that has passed into the mediastinum.
This is a typical finding and very important for the surgeon to recognize as the isthmus connection to the right lobe (usually seen arising on the right) is narrow and easily missed on dissection leaving a large mass of functioning thyroid tissue that can continue to grow leading to recurrence of compressive symptoms.