Perioperative management of an asymptomatic giant retrosternal goiter with high-risk imaging findings and an unanticipated cancer diagnosis: a case report

A retrosternal goiter (RSG) is defined as a thyroid mass with >50% of its volume extending into the mediastinum. Surgical resection is the definitive treatment. For patients with asymptomatic giant RSGs—a condition where watchful waiting is common yet carrying risks of compression and occult malignancy—the perioperative nursing literature lacks specific guidance. This creates a challenge in systematically addressing their dual needs: managing complex physiological risks (e.g., respiratory, neural) and providing psychological support for potential unexpected diagnoses. This case reports an asymptomatic patient with an incidental postoperative cancer. This report provides an indispensable reference for developing structured, evidence-based nursing protocols for this unique high-risk population.