Artificial Acellular Dermal Matrix Presenting as a Nodule in Thyroidectomy Patient

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 postthyroidectomy. 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.

Acellular Dermal Matrix Mistaken as Recurrence of Malignancy Following Surgery on Positron Emission Tomography/Computed Tomography: A Case Report

“…11 Histological evaluation of an ADM implanted into human tissue revealed successful integration of the ADM within 6 months. 6,10 However, Kim et al 12 reported that the ADM used to prevent adhesion after thyroidectomy was not absorbed 32 months after the surgery, which signifies variations in the rates of absorption of the ADM. In the current case, poor integration of the ADM into the host tissue was suspected to be caused by lack of vascularity due to thickening of the ADM by folding and its placement on the bony surface.…”