24716              MEDIASTINAL PROLONGATION OF THE THYROID

This 73-year old woman was admitted with a 12-month history of generalised lower abdominal pain. She was noted to have black bowel actions.  After a transverse colostomy and barium meal had suggested a pelvic neoplasm, she underwent anterior resection to remove a carcinoma of the sigmoid colon. She died after poor postoperative progress. Chest X-ray had shown an upper mediastinal mass.

The specimen shows a nodular goitre with a large left intra-thoracic prolongation of the left lower lobe. The left common carotid artery runs over its surface. The trachea has been deviated to the right and the extension reaches the aortic arch. Section of the thyroid (on the back of the specimen) shows a predominantly colloid goitre with little interstitial fibrosis but large areas of calcification especially in the capsule at the lower pole of the prolongation.