Simultaneous Seeding of Follicular Thyroid Adenoma Both Around the Operative Bed and Along the Subcutaneous Tunnel of the Upper Chest Wall after Endoscopic Thyroidectomy

Jung, Jo Sung; Kim, Shin Young; Jung, Hae Yoen; Han, Seon Wook; Lee, Jong Eun; Lee, Deuk Young

doi:10.3348/jksr.2017.76.2.138

Cited by 4 publications

(1 citation statement)

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“…Seeding recurrence after thyroidectomy has been previously documented for remote access approaches, particularly in endoscopic and robotic transaxillary and bilateral axillo-breast approach surgeries ( 9 - 11 ). Reports included both malignant and benign implantations along the surgical track, and were treated with surgical re-exploration for excision of thyroid tissue and/or radioactive iodine (RAI) therapy ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

Seeding recurrence of follicular thyroid carcinoma after transoral endoscopic thyroidectomy vestibular approach: a case report

Oh,

Kim

et al. 2024

Gland Surg

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Background While track recurrence of thyroid cancer following endoscopic and robotic transaxillary surgeries has been reported previously, no such cases have been reported for transoral endoscopic thyroidectomy vestibular approach (TOETVA). This case report describes the first documented case of recurrence of thyroid cancer along the surgical track after TOETVA. Case Description The patient underwent right lobectomy via TOETVA for a 4 cm follicular thyroid carcinoma (FTC) initially diagnosed as benign follicular nodule on preoperative gun biopsy. The thyroid capsule partially ruptured within the surgical field during surgery. Ultrasonography and computed tomography conducted 27 months after surgery revealed seeding recurrence in the postsurgical thyroid bed, and subcutaneous layers of the right lower lip, submental area, and mid to right upper neck levels I, IIA, and VI. Two-stage re-operation was done to perform completion thyroidectomy, lymph node dissection, and excision of recurrent nodules, which were pathologically confirmed as metastatic FTC. The patient underwent two treatments of radioactive iodine therapy, and post-therapeutic whole-body scintigraphy and computed tomography showed no residual disease. Conclusions Careful monitoring after TOETVA is essential due to the rare but potential risk of seeding recurrence, especially when the thyroid gland ruptures during surgery. Surgeons should be aware of this atypical complication and be prepared to recommend surgical and/or medical strategies to manage any local seeding of thyroid tissue that may occur.

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Section: Introductionmentioning

confidence: 99%

Seeding recurrence of follicular thyroid carcinoma after transoral endoscopic thyroidectomy vestibular approach: a case report

Oh,

Kim

et al. 2024

Gland Surg

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Track recurrence after remote‐access thyroid surgeries: A systematic review

Oh,

Chai

2024

World j. surg.

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BackgroundRemote‐access thyroidectomies have gained popularity, but track recurrence, which is the implantation of thyroid tissue or lesions along the surgical access route, has been reported in case studies. This systematic review aims to review cases of track recurrence following remote‐access thyroidectomies.MethodsA comprehensive literature search was conducted using PubMed, the Web of Science, the Cochrane Library, and Google Scholar to identify case reports on track recurrence after endoscopic or robotic thyroidectomy up to June 2024. Data included patient demographics, details of the initial surgery and diagnosis, methods and timing of recurrence detection, and management strategies.ResultsThe search yielded 1578 articles, of which 17 case reports comprising 18 patients were included. The patients (16 females and two males) had a mean age of 34.6 ± 14.9 years. The mean size of initial tumors was 3.9 ± 1.2 cm, with diagnoses of eight cancers and 10 benign lesions. The initial surgeries included 12 endoscopic and six robotic procedures. Track recurrence was most often detected by palpable nodules followed by routine imaging and elevated serum Tg levels. The interval between initial surgery and recurrence ranged from 3 months to 8 years. Management varied from surgical resection and radioactive iodine therapy to close observation. There were no further recurrences in all but one case postoperatively.ConclusionTrack recurrence after remote‐access thyroidectomy is rare but significant. Proper surgical techniques, careful handling of thyroid tissue, and rigorous postoperative monitoring are essential to minimize this risk. Awareness and prompt management of track recurrence may lead to favorable outcomes.

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