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Med Bull Sisli Etfal Hosp. 2022; 56(2): 167-176 | DOI: 10.14744/SEMB.2022.30806 | |||
Substernal guatr: Tanımlarından tedavi yöntemlerineMehmet Taner Unlu1, Nurcihan Aygun1, Mehmet Kostek1, Adnan Isgor2, Mehmet Uludag11Türkiye Sağlık Bilimleri Üniversitesi, Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Genel Cerrahi Anabilim Dalı, İstanbul2Şişli Memorial Hastanesi, Genel Cerrahi Kliniği, İstanbul Multinodüler guatrın (MNG) torasik giriş yoluyla mediasten içine doğru büyümesi veya direk olarak mediasten içindeki ektopik tiroid dokuları Substernal Guatr (SG) olarak tanımlanmaktadır. Ancak bu tanım ile ilgili literatürde net bir konsensus bulunmamaktadır. Substernal Goiter: From Definitions to TreatmentMehmet Taner Unlu1, Nurcihan Aygun1, Mehmet Kostek1, Adnan Isgor2, Mehmet Uludag11Department of General Surgery, Division of Endocrine Surgery, University of Health Sciences Turkey, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey2Deparment of General Surgery, Sisli Memorial Hospital, Istanbul, Türkiye The enlargement of multinodular goiter into the mediastinum through the thoracic inlet or ectopic thyroid tissues directly in the mediastinum is defined as Substernal Goiter (SG). However, there is no clear consensus in the literature on this definition. There are many definitions for SG in the literature. Most definitions are similar or overlapping. Since the thyroid is located in the neck above the thoracic inlet in its normal anatomical position, the simplest clinical definition should be preferred among the definitions regarding its descent below the thoracic inlet and adjacent to the mediastinal organs. In the American Thyroid Association guideline, SG is defined as clinical or radiological protrusion of the thyroid gland over the sternal notch or clavicle in a patient with a slightly extended neck in the supine position. SGs can be classified as primary or secondary according to their origins. In addition, there are combined SGs resulting from the enlargement of the primary SG, which is the growth of the cervical thyroid gland toward the mediastinum, and the secondary SG, which is defined as an ectopic mediastinal mass, together. We find it appropriate to define such SGs as mixed SGs. In this disease, which has the same etiology and etiopathogenesis as cervical goiter, the descent of the thyroid gland into the mediastinum due to some anatomical factors explains the physiopathology. Compression symptoms of mediastinal major vascular structures, trachea, and esophagus cause the symptoms and findings of SGs due to its localization. In addition, the relationship of SGs with possible malignancy risk and hyperthyroidism affecting the indications and methods of treatment has been discussed for a long time. In this study, we aimed to evaluate the definitions, classification, physiopathology, laboratory and imaging methods used for diagnosis, the relationship of SG with hyperthyroidism and malignancy, and briefly the treatment methods, according to the current studies from literature. Keywords: Definitions, diagnostic methods, physiopathology, substernal goiter, treatmentMehmet Taner Unlu, Nurcihan Aygun, Mehmet Kostek, Adnan Isgor, Mehmet Uludag. Substernal Goiter: From Definitions to Treatment. Med Bull Sisli Etfal Hosp. 2022; 56(2): 167-176 Sorumlu Yazar: Mehmet Taner Unlu |
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