Comparison of clinical and radiological findings in patients with retrosternal and cervical goiters

We analyzed the correlation of clinical and radiological findings in the diagnosis of large cervical and retrosternal nodular goitres. Fourteen symptomatic patients were studied (12 female and 2 male). Nine of them had retrosternal goitre. All underwent computed tomography (CT) of the neck and upper mediastinum, thyroid scintigraphy using Tc-99m-pertechnetate and contrast radiology of the oesophagus. Problems with respiration (stridor) were present in five patients, but four of them had CT findings of tracheal compression. The other nine patients had no respiratory problems, and CT revealed tracheal compression in two cases. Nine patients had the dislocation of the trachea on CT. Dysphagia was present in eight cases but only three patients had radiological signs of oesophageal narrowing. These patients also had the dislocation of the oesophagus, revealed by contrast radiology, just as five others without any swallowing problems. The results demonstrate that all patients with respiratory problems do not necessary have tracheal compression (indicating the possible affection of the phrenic nerve). On the other hand, some patients can have tracheal narrowing without any respiratory problems. (author)