In retrosternal goiter, most common presenting feature is –

**Core Concept**
Retrosternal goiter refers to the extension of a thyroid gland mass into the thoracic cavity, behind the sternum. This condition is often caused by an enlargement of the thyroid gland, which can compress adjacent structures and lead to various symptoms.

**Why the Correct Answer is Right**
The most common presenting feature of retrosternal goiter is dyspnea, or shortness of breath. This occurs due to the compression of the trachea and/or the major airways by the enlarged thyroid gland, leading to impaired respiratory function. The trachea may be deviated or compressed, causing difficulty in breathing. In some cases, the compression may also lead to vocal cord paralysis, resulting in hoarseness of voice.

**Why Each Wrong Option is Incorrect**
**Option A:** Cough. While cough may be present in some cases of retrosternal goiter, it is not the most common presenting feature.
**Option B:** Chest pain. Chest pain can occur due to compression of the thoracic cavity structures, but it is not the primary symptom of retrosternal goiter.
**Option C:** Dysphagia. Dysphagia or difficulty swallowing may occur in cases where the esophagus is compressed, but it is not the most common presenting feature of retrosternal goiter.

**Clinical Pearl / High-Yield Fact**
A key clinical correlation to remember is that retrosternal goiter can be associated with other thyroid disorders, such as hypothyroidism or hyperthyroidism. Therefore, a thorough evaluation of thyroid function should be performed in patients with suspected retrosternal goiter.

**Correct Answer:** C. Dyspnea. Dyspnea is the most common presenting feature of retrosternal goiter.

✓ Correct Answer: C. Dyspnoea