Non-Surgical Approaches to the Management of the Intrathoracic Goiter-A Systematic Review

Background: Intrathoracic goiters (ITGs) are usually managed by surgical excision, However, over recent years, non-surgical strategies are emerging as an alternatives for treating this condition. Methods: A systematic review of research published since 2017 in the PubMed database was conducted and a total of 39 articles were retrieved, along with methodological issues and future directions in the research on ITGs. Results: Several non-surgical treatments exist, including radio-iodine ablation (RIA) and mini-invasive approaches, such as transcervical microwave ablation (TcMA), transcervical radiofrequency ablation (TcRfA), or selective embolization of the thyroid arteries (SETA). Despite encouraging reports, their current use remains limited. Conclusions: Treatment of ITGs requires a multidisciplinary thyroid team, and when non-surgical options are chosen, patients need to be carefully selected, and their outcomes must be prudently considered and discussed with the patient. Keywords: embolization; goiter; head and neck; radiofrequency; thyroid surgery.