Korean J Endocr Surg.  2014 Dec;14(4):235-239. 10.0000/kaes.2014.14.4.235.

Subcutaneous Soft Tissue Implantation of Papillary Thyroid Carcinoma after Endoscopic Thyroidectomy

• Cho J
• Kang SH

• KMID: 2375447
• DOI: http://doi.org/10.0000/kaes.2014.14.4.235

Abstract

Endoscopic thyroidectomy with bilateral axillo-breast approach (BABA) is a feasible method of thyroidectomy with good surgical outcome and excellent cosmetic result as compared with conventional open thyroidectomy in selective patients. Thus, endoscopic thyroidectomy is widely used in treatment of thyroid diseases. However, despite the many advantages, we sometimes encounter unexpected complication, such as neck stiffness caused by adhesion, change of sensory, seroma formation, and subcutaneous soft tissue implantation. Subcutaneous soft tissue implantation of thyroid tissue is a very rare complication of thyroid surgery. However, it is troublesome to both patient and doctor. We experienced a case of papillary thyroid carcinoma recurrence at anterior and antero-lateral subcutaneous area after endoscopic total thyroidectomy. Our case presented with a papillary thyroid carcinoma measuring 2.1 cm in size and showed thyroidal capsule invasion and extra-thyroidal extension on the permanent pathologic report. Therefore, we suggest that appropriate indications should be applied for an endoscopic thyroidectomy and efforts should be made to decrease tumor cell spillage in order to prevent tumor rupture, and for careful handling and protection of the extraction site.

Keyword

Subcutaneous soft tissue implantation; Papillary thyroid carcinoma; Endoscopic thyroidectomy

MeSH Terms

Humans
Neck
Recurrence
Rupture
Seroma
Thyroid Diseases
Thyroid Gland
Thyroid Neoplasms*
Thyroidectomy*

Figure

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  Fig. 1. Neck ultrasonography and neck computed tomography show a 17×12×13 mm sized ovalshaped, well demarcated solid nodule in the right upper portion of thyroid.

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  Fig. 2. The neck ultrasonography shows two nodules in the medial border of right sternocleidomastoid (SCM) muscle, 6 mm sized in the anterior midline and with superior location of another nodule, about 5 mm sized (A, B, D). The PET-CT shows a mildly hypermetabolic nodule at the medial border of right SCM muscle (C).

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  Fig. 3. The PETCT shows three newly formed mildly hypermetabolic lesions in the subcutaneous layer of medial and left sided neck and the skin (A ∼C, G). The same suspicious lesion was noted on the neck USG (D∼F).

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  Fig. 4. Changes of serum TG according to recurrence and operation. Serum TG was stable after the third operation.

Reference

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