Endocrine Abstracts

Introduction: ‘Forgotten goiter’ is defined as a mediastinal thyroid mass discovered after total thyroidectomy. It is a rare clinical finding, usually asymptomatic.

Case report: 88-years old woman was admitted to the Endocrinology Department with a suspicion of the retrosternal goiter. In her medical history there was thyroidectomy performed 16 years before because of multinodular goiter and she had recurrent lower respiratory tract infections in the last few months. She did not present any symptoms of impaired hormonal secretion, however thyroid function tests showed subclinical hyperthyroidism. Chest X-ray and then CT examination revealed in the thoracic cavity a mass reaching to the diaphragm and connected with the thyroid. Technetium 99 m pertechnetate scans confirmed that as a thyroid mass. Taking into consideration patient’s age and contraindications to the surgery, the decision about treatment with radioactive iodine was made and patient received 20 mCi I-131. Three months after therapy patient was euthyroid, however a year after recurrence of a subclinical hyperthyroidism was found. Patient was treated with radioiodine in a dose of 20 mCi again. 15 months after the second radioiodine administration, patient remained euthyroid and a volume of the goiter has decreased.

Conclusion: In the literature there are described case reports of patients diagnosed with ‘forgotten goiters’, but the treatment of choice was surgery, what was contraindicated in our patient. What is more, the goiter of a size as the one diagnosed in reported patient is extremely rarely found.