경구강 접근 갑상선절제술 후 수술 경로를 따라 발생한 갑상선암의 이식성 전이
Tract Implantation of Thyroid Carcinoma After Transoral Thyroidectomy
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Transoral thyroidectomy is a promising technique because of its superior postoperative cos-mesis. Although tract implantation after remote-access thyroidectomy is extremely rare, it canresult in poor outcomes. A 45-year-old female presented with multiple palpable nodules in theanterior neck after a transoral thyroidectomy for which thyroid function tests, CT, ultrasonog-raphy, and fine-needle aspiration were performed. The thyroid function test results were nor-mal. CT and ultrasonography revealed multiple, well-defined nodules at levels Ia and VI alongthe tracks left by the endoscopic instrument inserted during transoral thyroidectomy. Fine-needle aspiration revealed a microfollicular structure derived from thyroid tissue without evi-dence of atypia. Wash-out fluid from the nodules revealed elevated thyroglobulin levels. Initial-ly, the patient was hesitant about surgical removal, but the nodules grew larger, so surgicalremoval was performed. Final histopathological examination revealed follicular thyroid carci-noma. The patient was recommended extensive resection but was lost to follow-up.
Abstract
Transoral thyroidectomy is a promising technique because of its superior postoperative cos-mesis. Although tract implantation after remote-access thyroidectomy is extremely rare, it canresult in poor outcomes. A 45-year-old female presented with multiple palpable nodules in theanterior neck after a transoral thyroidectomy for which thyroid function tests, CT, ultrasonog-raphy, and fine-needle aspiration were performed. The thyroid function test results were nor-mal. CT and ultrasonography revealed multiple, well-defined nodules at levels Ia and VI alongthe tracks left by the endoscopic instrument inserted during transoral thyroidectomy. Fine-needle aspiration revealed a microfollicular structure derived from thyroid tissue without evi-dence of atypia. Wash-out fluid from the nodules revealed elevated thyroglobulin levels. Initial-ly, the patient was hesitant about surgical removal, but the nodules grew larger, so surgicalremoval was performed. Final histopathological examination revealed follicular thyroid carci-noma. The patient was recommended extensive resection but was lost to follow-up.
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