Goitre (Intrathoracic) in Acromegaly (Rad; PA)	

Fig. 23.39a Intrathoracic goitre in acromegaly. The PA chest film shows a large mass in the right upper chest which is confluent with the mediastinum medially and has a well-defined lateral margin. The mass does not contain any obvious calcification and is only slightly displacing the trachea to the left. The right lateral view (b) shows a clearly defined mass lying posteriory. The patient had presented with a goitre and had noticed some enlargement of the hands and feet. There were no symptoms of dysphagia or of thyrotoxicosis. The mass in the chest was subsequently shown on T scans to be in continuity with the cervical goitre. The patient was also found to have a pituitary tumour and acromegaly.