Artificial Acellular Dermal Matrix Presenting as a Nodule in Thyroidectomy Patient
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Postoperative adhesion after total thyroidectomy induces discomfort such as pain, hyperesthesia of anterior neck and swallowing difficulty. To prevent postoperative adhesion, various anti-adhesion barriers were introduced. Adhesion barrier are generally considered to be well tolerable and safe, however few cases of delayed adverse effects are reported. Persistent adhesion barrier agent on operation site is one of the rare complications. This study aimed to review the literature, and discuss the etiology and management of persistent artificial acellular dermal matrix (ADM) after thyroidectomy. Herein, we presented a case who presented as a nodule after applying artificial ADM which lasted 32 month post-thyroidectomy. A 64-year-old woman underwent left hemi thyroidectomy and ipsilateral central compartment node dissection (CCND) for papillary thyroid carcinoma (PTC). Seven months later operation, her neck ultrasonography (US) revealed a hypoechoic mass on left operation bed, which was suspicious for recurred mass, granulation tissue or neuroma. After excision of mass, the final histopathologic diagnosis was rolled ADM.
Abstract
Postoperative adhesion after total thyroidectomy induces discomfort such as pain, hyperesthesia of anterior neck and swallowing difficulty. To prevent postoperative adhesion, various anti-adhesion barriers were introduced. Adhesion barrier are generally considered to be well tolerable and safe, however few cases of delayed adverse effects are reported. Persistent adhesion barrier agent on operation site is one of the rare complications. This study aimed to review the literature, and discuss the etiology and management of persistent artificial acellular dermal matrix (ADM) after thyroidectomy. Herein, we presented a case who presented as a nodule after applying artificial ADM which lasted 32 month post-thyroidectomy. A 64-year-old woman underwent left hemi thyroidectomy and ipsilateral central compartment node dissection (CCND) for papillary thyroid carcinoma (PTC). Seven months later operation, her neck ultrasonography (US) revealed a hypoechoic mass on left operation bed, which was suspicious for recurred mass, granulation tissue or neuroma. After excision of mass, the final histopathologic diagnosis was rolled ADM.
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