Recently, the Department of General Surgery of the Fifth Affiliated Hospital of Zhengzhou University treated an elderly female patient with a huge retrosternal goiter, and successfully resected both sides of the goiter, which were 26 cm×5 cm×5 cm (about 750 grams) and 9.5 cm×4.5 cm×4.5 cm (about 300 grams), respectively, and the patient was discharged from the hospital. The complete resection of such a huge retrosternal goiter without opening the chest signifies that our hospital has reached a fairly high level in the comprehensive treatment of thyroid disease. Patient Guo Mou, female, 73 years old, from Longquan District, Luoyang City. She was admitted to the Department of Thoracic Surgery of our hospital because of “space-occupying lesion in the upper mediastinum”. Upon further examination, it was found that the patient’s bilateral thyroid glands were obviously enlarged, and the left thyroid gland reached the aortic arch in the mediastinum behind the sternum and the trachea and esophagus were severely compressed. The patient was referred to our department after consultation. It was extremely difficult and risky to completely remove the tumor without opening the chest for such a huge retrosternal goiter, for this reason, experts from the Department of General Surgery, Department of Thoracic Surgery, Department of Anesthesiology, and other departments of the hospital organized a consultation and discussion, and formulated a thorough surgical plan and emergency treatment measures, and then the surgical team headed by Director Cui Xiaobing performed the surgery for Guo, and the retrosternal mediastinum thyroid was completely removed. The operation went smoothly. After the operation, the patient recovered well without any complications and was discharged from the hospital. Nodular goiter refers to the multiple nodules formed in the late stage of endemic goiter and sporadic goiter, the incidence rate is very high, more women than men, the nodules are small in the early stage, and most of the patients do not have self-conscious symptoms, but the disease progresses, and the nodules increase in size, there may be difficulty in swallowing, hoarseness and dyspnea, etc. 4-7% of the nodular goiters may have malignant transformation, so the early implementation of the operation is an important measure for the prevention of thyroid cancer. Therefore, early surgical treatment is an important measure to prevent thyroid cancer.