Background: Substernal goiters are frequently associated with compressive symptoms. Compression of the trachea and esophagus are common, whereas thoracic duct compression is a rare occurrence.
Methods: We report a rare case of a 72-year-old woman with thoracic duct compression by a large substernal goiter that presented with shortness of breath. After undergoing thoracentesis multiple times, the patient was treated with thyroidectomy.
Results: Transcervical thyroidectomy was performed without sternotomy. This led to resolution of her symptoms. Confirmation of chylothorax resolution was obtained with postoperative computed tomography of the chest.
Conclusion: Chylothorax is a rare sequela of substernal goiters. It can be managed with thyroidectomy. Sternotomy was avoided in this case.