Retrosternal goitre involving Zuckerkandl's tubercle

Case contributed by A.Prof Frank Gaillard

Presentation

This patient went to the OR for a kidney stone procedure and when induced quickly desaturated. Bagging did not work well and the patient was given an emergency tracheostomy by urology.

Patient Data

Age: Adult

A soft tissue mass to the right of the trachea in the superior mediastnum. The airway is distorted and a little narrowed. Note how the upper border of this mass is not visible, suggesting it is in the anterior aspect of the superior mediastinum (we knew that anyway, since it is distorting the trachea). This is known as the cervicothoracic sign.  

Retrosternal goitre involving Zuckerkandl's tubercle distorting and narrowing the trachea. A tracheostomy has been inserted. 

Case Discussion

This case highlights the importance of properly reviewing pre-operative chest x-rays for potential anaesthetic difficulties. 

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Case information

rID: 9922
Case created: 31st May 2010
Last edited: 22nd Mar 2017
Systems: Chest, Head & Neck
Inclusion in quiz mode: Included

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