Utilization of cardiopulmonary bypass for resection of a massive left retrotracheal thyroid goiter: a case report and review of literature at a tertiary care hospital in Saudi Arabia

Substernal goiter consists of thyroid tissue extending into the thoracic cavity and is more common in females. Total thyroidectomy is standard, though some cases require advanced approaches. Cardiopulmonary bypass (CPB) may be considered in selected cases for hemodynamic stability. We aimed to describe a rare case of retrotracheal thyroid goiter managed using CPB and review reported surgical approaches. A 39-year-old male presented with hoarseness and palpitations due to a left-sided retrotracheal thyroid goiter. Initial cervical access was unsuccessful, requiring median sternotomy with CPB for safe resection. Histopathology confirmed a benign follicular nodule, and the postoperative course was uneventful. CPB can be a valuable adjunct in complex retrotracheal substernal goiters, highlighting the importance of individualized surgical planning and a multidisciplinary approach.