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Sub-Sternal Thyroid

Hi!  I am a 44 year-old female who has just been diagnosed with a sub-sternal thyroid goiter.  I am concerned because I just had heart surgery 8 months ago to repair a congenital defect and am still having soreness and tenderness in my rib cage and I understand that sometimes the rib cage has to be split to get all of the sub-sternal goiter out.  Ouch!  I haven't really had any symptoms except that with I bend over, that area of my throat throbs.  I was diagnosed with a multi-nodule goiter 8 years ago and had radioactive iodine, but apparently it didn't work.  I take levothyroxine (.075) every day to supplement what my gimpy thyroid does not produce.

My questions are:
1) How common is this type of goiter and what are the complications that most often come with it?
2) How common is it to have to split the rib cage to get all of the sub-sternal goiter out?  
3) How likely is it that the goiter is cancerous?
4) If it is cancer, how easy is it to cure and what is the prognosis after treatment? (Will it come back?, etc.)

I'm sorry to be so long-winded, but this really freaking me out and I am not having much luck finding information on the web.  I would love to talk to people who have/had a sub-sternal goiter to see how it has affected them.

Thank you!
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Avatar universal
Not sure what more one can say except that as long as your surgeon is well experienced you'll be fine and will recover quickly.
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Avatar universal
I was diagnosed with a Thyroid Mass pressing down on my chest on April 18 I was having chest pain and they did a ct scan and found it so I went to see a ENT specialist and she was like have to take this out immediately so I'm schedule to have surgery May 8 2014 . I'm very scared but need to hear and get it out because it difficult to get food down that stop in my throat .
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Avatar universal
I just had my surgery five days ago for a softball size substernal goiter that had caused my windpipe to almost totally close up. It advanced suddenly after an abcessed tooth and I had severe shortness of breath. Surgery was imperitive and necessary. Yes, it was scary and I have been home for a full day now and I feel great!!! I didn't even need pain medicine. The surgeon said it was the largest he had seen and if I had put it off much longer, it would have killed me. I am much stronger now and I have more energy. Don't put it off!!!  High blood pressure isn't the only silent killer, Substernal goiters are, too.
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Avatar universal
I forgot to address your concern about cancer.  They were able to do an ultrasound biopsy and go down under the bone using the ultrasound and remove tissue.  They numbed it with several shots and I was able to watch it on the screen.  They did about 3 samples and found no cancer.  At the time, they did not know it had thyroid tissue in it.  You might want to check on that.  I had heard that they could not do a needle biopsy, but this was a little more complicated than that.  
GlendaE
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Avatar universal
I was diagnosed with a large substernal thyroid mass about 3 years ago.  It is pushing the trachea to the side.  My understanding is that it might be OK for years, but there could come an emergency of some kind and it could grow quickly or be displaced.  I have read that surgery is the only recourse.  HOWEVER, my doctor put me on low doses of levothyroxine and does a CT scan of my chest every 6 months.  I had a thyroidectomy almost 30 years ago and they left part of one lobe.  I have never needed medication until this started.  Also, I have started having some problems with my heart and blood pressure since then.  I am not overweight and they think the thyroid mass is the cause.  I didn't answer your question, did I?  I am just as perplexed as to what to do.
GlendaE
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Avatar universal
That is SO fascinating about manipulating the goiter down into the chest!  They must have thought it was a cool magic trick!  Thanks for responding!  I am so glad to have the forum to talk with others who have thryoid issues!
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168348 tn?1379357075
On for only a few mins. but do a search in archives for member Venoramoonwind .. she had that same surgery about 1.5yrs ago!  

WELCOME!

Cheryl
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Avatar universal
898
The substernal goiter is may form when the thyroid gland lies to low in neck under substernal notch due to anatomical variation.
Many substernal goiters can be pulled out without the rib cage dissection using incision at the base of the neck.
The substernal goiter carries same risks for cancer as non-substernal one.
Interstingly enough, in the past some tribal "doctors" used to heal(!) the visible goiter by manipulating it down into the thoratic cavity.


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