Large left goiter, displacing the larynx and trachea to the right of the midline (green vertical line) and extending into the upper mediastinum, behind the left clavicle and manubrium of the sternum.
Surgical photograph of above substernal goiter, removed via a cervical approach. In this picture, the substernal component has been "delivered" and the whole left lobe has been retracted anteriorly outside the wound, while still attached to the trachea and isthmus.
The photograph on the right shows the specimen mounted and properly oriented for the pathologist to perform a frozen section.