Abstract
Intrathoracic goiters can be classified as primary or secondary. Primary intrathoracic goiters are characterized by the absence of any anatomical connection with the cervical thyroid gland, in contrast to secondary intrathoracic goiters. A rare variant, termed mixed or combined intrathoracic goiter, involves the synchronous presence of both primary and secondary components within the thoracic cavity. Given the rarity and the diagnostic challenges associated with these conditions, we report the case of a patient who presented with a multinodular goiter and a separate right paratracheal mediastinal mass. The latter was identified as ectopic thyroid tissue, consistent with a primary intrathoracic goiter. We describe the diagnostic approach used to differentiate the mediastinal mass from other thoracic pathologies, as well as the successful surgical management performed via a minimally invasive technique and facilitated a rapid and uneventful postoperative recovery.