In retrosternal goiter, most common presenting feature is -

Ans. is 'C' Dyspnoea A goitre is said to be retrosternal, substernal or mediastinal if more than half of the thyroid tissue is below the opening of thoracic cage. It usually arises from the lower pole of a nodualr goitre. Rarely it arises from ectopic thyroid tissue. It is often symptomless, and is discovered on a routine chest radiograph. There may however be severe symptoms due to mass effect on the trachea, esophagus, great vessels and nerves. dyspnoea paicularly at night, cough & stridor - dysphagia - enlargement of neck veins and superficial veins on the chest wall. - recurrent nerve palsy. - Pembeon's sign - refers to symptoms of faintness with evidence of facial congestion and external jugular venous obstruction when the arms are raised above the head. Nowhere, we could get text stating the most common symptom, but reading from Bailey & other more elaborate textbooks on thyroid, dyspnea appears to be the most common symptom. Logically, trachea being the most closely relate structure, is compressed earliest.