Case: 10-cm right thyroid mass falling into the posterior sternum, multiple nodules in the left thyroid gland Procedure: total thyroidectomy with preparation for open sternal post-thyroidectomy Surgical procedure: an anterior cervical collar incision was made to fully expose the thyroid gland, the right lower pole was freed and then gradually pulled upward to separate the adhesions between the thyroid gland and the upper limb vessels, and the nodules were eventually retracted to avoid open-heart surgery. Results: recovery was still smooth, no manifestation of injury to the laryngeal recurrent nerve and parathyroid glands, postoperative effusion in the thyroid fossa, follow-up after sexual puncture. Lessons learned: huge goiters have little room for operation, are difficult to operate, and have the risk of open-heart surgery, with a large postoperative residual trauma cavity and a greater risk of effusion, therefore, thyroid nodules should be operated on as early as possible.