Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2024; 12(3): 643-649
Published online Jan 26, 2024. doi: 10.12998/wjcc.v12.i3.643
Pathological diagnosis and immunohistochemical analysis of giant retrosternal goiter in the elderly: A case report
Yong-Chang Meng, Liu-Sheng Wu, Ning Li, Hong-Wei Li, Jing Zhao, Jun Yan, Xiao-Qiang Li, Peng Li, Jiang-Qi Wei
Yong-Chang Meng, Hong-Wei Li, Jiang-Qi Wei, Department of Cardiothoracic Surgery, Xinxiang First People's Hospital, Xinxiang 453000, Henan Province, China
Liu-Sheng Wu, Jun Yan, School of Clinical Medicine, Tsinghua University, Beijing 100084, China
Ning Li, Graduate School, Qinghai University, Xining 810016, Qinghai Province, China
Jing Zhao, Department of Pathology, Xinxiang First People's Hospital, Xinxiang 453000, Henan Province, China
Xiao-Qiang Li, Peng Li, Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
Co-first authors: Yong-Chang Meng, Liu-Sheng Wu and Ning Li.
Co-corresponding authors: Jiang-Qi Wei and Jun Yan.
Author contributions: Meng YC and Wu LS analyzed the data and wrote the paper; Li XQ and Wei JQ designed the research; Yan J and Li P guided the research; Zhao J, Li HW and Li N collected and downloaded the data of our research; All the authors revised it critically for important intellectual content, gave final approval of the version to be published and agreed to be accountable for all aspects of the work. The reasons for designating Wei JQ and Yan J as co-corresponding authors are threefold. First, the research was performed as a collaborative effort, and the designation of co-corresponding authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, the overall research team encompassed authors with a variety of expertise and skills from different fields, and the designation of co-corresponding authors best reflects this diversity. This also promotes the most comprehensive and in-depth examination of the research topic, ultimately enriching readers' understanding by offering various expert perspectives. Third, Wei JQ and Yan J contributed efforts of equal substance throughout the research process. The choice of these researchers as co-corresponding authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Wei JQ and Yan J as co-corresponding authors of is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Supported by the Scientific Research Foundation of Peking University Shenzhen Hospital, No. KYQD202100X; the National Natural Science Foundation of China, No. 81972829; and Precision Medicine Research Program of Tsinghua University, No. 2022ZLA006.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jiang-Qi Wei, PhD, Doctor, Department of Cardiothoracic Surgery, Xinxiang First People's Hospital, No. 63 Yiheng Street, Weibin District, Xinxiang 453000, Henan Province, China. 2733514758@qq.com
Received: November 9, 2023
Peer-review started: November 9, 2023
First decision: November 22, 2023
Revised: November 22, 2023
Accepted: January 3, 2024
Article in press: January 3, 2024
Published online: January 26, 2024
Processing time: 69 Days and 17.9 Hours
Abstract
BACKGROUND

Elderly giant retrosternal thyroid goiter is a rare yet significant medical condition, often presenting clinical symptoms that can be confused with other diseases, posing diagnostic and therapeutic challenges. This study aims to delve into the characteristics and potential mechanisms of this ailment through pathological diagnosis and immunohistochemical analysis, providing clinicians with more precise diagnostic and treatment strategies.

CASE SUMMARY

A 77-year-old male, was admitted to hospital with the chief complaint of finding a goiter in the semilunar month during physical examination, accompanied by dyspnea. Locally protruding into the superior mediastinum, the adjacent structure was compressed, the trachea was compressed to the right, and the local lumen was slightly narrowed. The patient was diagnosed with giant retrosternal goiter. Considering dyspnea caused by trachea compression, our department planned to perform giant retrosternal thyroidectomy. Immunohistochemical results: Tg (+), TTF-1 (+), Calcitonin (CT) (I), Ki-67 (+, about 20%), CD34 (-). Retrosternal goiter means that more than 50% of the volume of the thyroid gland is below the upper margin of the sternum. As retrosternal goiter disease is a relatively rare disease, once the disease is diagnosed, it should be timely surgical treatment, and the treatment is more difficult, the need for professional medical team for comprehensive treatment.

CONCLUSION

The imaging manifestations of giant retrosternal goiter are atypical, histomorphology and immunohistochemistry can assist in its diagnosis. This article reviews the relevant literature of giant retrosternal goiter immunohistochemistry and shows that giant retrosternal goiter is positive for Tg, TTF-1, and Ki-67.

Keywords: Giant retrosternal goiter; Pathology; Immunohistochemistry; Case report

Core Tip: Elderly giant retrosternal thyroid goiter is a rare yet significant medical condition, often presenting clinical symptoms that can be confused with other diseases, posing diagnostic and therapeutic challenges. The diagnosis of elderly giant retrosternal thyroid goiter is difficult and often results in unnecessary or inappropriate treatment. Therefore, it is particularly important to correctly identify and diagnose the disease, and this article reports a 77-year-old male patient with giant retrosternal goiter.