INTRATHORACIC GOITER

In spite of the fact that many authors have repeatedly written about the dangers of permitting adenomatous goiters to become intrathoracic, the likelihood and dangers of this occurrence are still not sufficiently appreciated. Failure to remove an adenomatous goiter which is extending beneath the clavicles and sternum before it has become deeply intrathoracic constantly results in the patient's being exposed to the necessity of submitting himself to a procedure involving a dissection deep in the mediastinum, to the dangers and mechanical difficulties of extracting a large adenomatous tumor from deep in the superior mediastinum and to the often perplexing problem of making a mediastinal tumor twice the diameter of the superior thoracic strait pass through that aperture in its surgical delivery.

The most common type of goiter which becomes intrathoracic is the discrete adenoma originating as a small single adenoma in the lower pole of the thyroid and gradually descending