Korean J Endocr Surg.  2016 Jun;16(2):48-50. 10.16956/kaes.2016.16.2.48.

Surgical Management of Bleeding from the Superior Thyroid Artery after Core Needle Biopsy

• Lee J
• Kim BK
• Sun WY

• KMID: 2308570
• DOI: http://doi.org/10.16956/kaes.2016.16.2.48

Abstract

Thyroid core needle biopsy (CNB) is commonly used in diagnosis of thyroid neoplasia, and despite its low complication rate, the complications can be fatal. Here, we report on the surgical management of thyroid artery bleeding after core needle biopsy of a thyroid nodule. A 58-year-old woman who underwent core needle biopsy presented with neck bulging and pain that developed two hours after biopsy. A large hematoma surrounding her right superior thyroid artery was detected.

Keyword

Hematoma; Superior thyroid artery; Core needle biopsy; Complication

MeSH Terms

Arteries*
Biopsy
Biopsy, Large-Core Needle*
Diagnosis
Female
Hematoma
Hemorrhage*
Humans
Middle Aged
Neck
Thyroid Gland*
Thyroid Nodule

Figure

• 

  Fig. 1. Immediately after CNB, a pericapsular hematoma was found.

• 

  Fig. 2. Two hours after core needle biopsy. (A) A large subplatysmal hematoma anterior to the thyroid gland. (B) Color flow image showing the blood flow, indicating active bleeding.

Reference

1. Na DG, Kim JH, Sung JY, Baek JH, Jung KC, Lee H, et al. Core-needle biopsy is more useful than repeat fine-needle aspiration in thyroid nodules read as nondiagnostic or atypia of undetermined significance by the Bethesda system for reporting thyroid cytopathology. Thyroid. 2012; 22:468–475.

2. Sung JY, Na DG, Kim KS, Yoo H, Lee H, Kim JH, et al. Diagnostic accuracy of fine-needle aspiration versus core-needle biopsy for the diagnosis of thyroid malignancy in a clinical cohort. Eur Radiol. 2012; 22:1564–1572.

3. Screaton NJ, Berman LH, Grant JW. US-guided core-needle biopsy of the thyroid gland. Radiology. 2003; 226:827–832.

4. Quinn SF, Nelson HA, Demlow TA. Thyroid biopsies: fine-needle aspiration biopsy versus spring-activated core biopsy needle in 102 patients. J Vasc Interv Radiol. 1994; 5:619–623.

5. Park KT, Ahn SH, Mo JH, Park YJ, Park DJ, Choi SI, et al. Role of core needle biopsy and ultrasonographic finding in management of indeterminate thyroid nodules. Head Neck. 2011; 33:160–165.

6. Paja M, del Cura JL, Zabala R, Corta I, Lizarraga A, Oleaga A, et al. Ultrasound-guided core-needle biopsy in thyroid nodules. A study of 676 consecutive cases with surgical correlation. Eur Radiol. 2016; 26:1–8.

7. Novoa E, Gürtler N, Arnoux A, Kraft M. Role of ultrasound-guided core-needle biopsy in the assessment of head and neck lesions: a meta-analysis and systematic review of the literature. Head Neck. 2012; 34:1497–1503.

8. Kakiuchi Y, Idota N, Nakamura M, Ikegaya H. A fatal case of cervical hemorrhage after fine needle aspiration and core needle biopsy of the thyroid gland. Am J Forensic Med Pathol. 2015; 36:207–209.