Surgical tactics in thyroid tumors located in the posterior mediastinum

The article described a rare clinical case of retrosternal follicular thyroid cancer located in the posterior mediastinum. The tumor was 11 cm in diameter, originating from the lower section of the right thyroid lobe, descended down retrosternally, while bulging out the internal jugular vein and common carotid artery. The tumor descended in the posterior mediastinum, from behind the subclavian artery and vein, adjoining posterior - to the back of the esophagus, medial ? to the trachea, anterior - to the superior vena cava, and bordered the lower arc of the subclavian vein, inferior right - to the right main bronchus, and caused compression of structures described above. With such a location of the tumor and its size performing surgery by cervical access poses serious technical difficulties, while sternotomy does not fully ensure adequate and secure access to the posterior mediastinal tumor. Therefore, the most efficient access in the case of retrosternal goiter located in the posterior mediastinum would be the combination of thoracotomy in the fifth intercostal space with cervical access via the front of the neck.