Substernal goiters are frequently associated
with symptoms of local compression, including dyspnea,
dysphagia and hoarseness. Rarely, an enlarged thyroid
can cause venous compression of the mediastinal
structures, compression of the thoracic duct is
exceptional and may be manifested by chylothorax.
We report a rare case of a 36-year-old woman with
compression of the thoracic duct by a large goiter who
presented with dyspnea. After undergoing chest
drainage associated with a low-fat oral diet, the patient
was treated with thyroidectomy.
A trans-cervical thyroidectomy with ligation of the
thoracic duct was performed without the need for a
sternotomy. This led to resolution of her symptoms.
Confirmation of resolution of chylothorax was obtained
by postoperative CT scan. Chylothorax is a rare sequel
to substernal goiter. It can be managed by
thyroidectomy, the trans-cervical approach remains
feasible. Sternotomy was avoided in this case
Keywords : Sub-Sternal Goiter- Chylothorax- Surgery