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Arch Surg. 1940;41(2):364-369. doi:10.1001/archsurg.1940.01210020160016.
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Substernal and intrathoracic goiters differ only in degree. In the present series, when the major portion of a goiter occurred above the sternum, with only prolongations extending below it, the growth was classified as substernal, and when an entire adenoma was below the level of the sternal notch it was classified as intrathoracic. In the past ten years 173 substernal and intrathoracic goiters have been encountered, and during that same period, 1,334 operations on the thyroid were performed, giving an incidence of 12.9 per cent of abnormally situated goiters. Nine of the 173 patients, or 5.2 per cent, had had one or more previous operations on the thyroid gland, varying from eight months to twenty-one years. The recurrence of eight months was undoubtedly present at the time of the first operation, but the recurrence occurring twenty-one years after the first operation may or may not have been present at the


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