Advertisement

Langenbeck's Archives of Surgery

, Volume 395, Issue 7, pp 873–876 | Cite as

Is fine-needle aspiration cytology for thyroid nodules a routine and safe procedure? A series of emergency cervicotomies following FNAC

  • Gianluca DonatiniEmail author
  • Tiziano Masoni
Endocrine Surgery

Abstract

Purpose

Fine-needle aspiration cytology (FNAC) is a widely used diagnostic tool to assess thyroid lesions, with a low morbidity rate. Although neck hematomas following FNAC are reported, only four cases of massive hemorrage resulting in acute airways obstruction have been previously described.

Methods

We report a series of three emergency cervicotomies for a massive neck hematoma causing acute respiratory distress after a thyroid FNAC.

Results

Endotracheal intubation followed by decompressive cervicotomy and surgical neck exploration was made in all patients. Two patients underwent isthmectomy, while a left thyroid lobectomy plus left lateral neck limphadenectomy was performed in the third case. Extubation was achieved within 12 h in the ICU. All patients were discharged uneventfully within 72 h.

Conclusions

Acute thyroid hemorrage is a very rare but possible complication of FNAC, potentially fatal for the patient. Prompt evaluation and intervention is mandatory for patients with rapidly evolving symptoms.

Keywords

Thyroid Airways obstruction Neck hematoma Fine-needle aspiration cytology 

References

  1. 1.
    Pacini F, Schlumberger M, Dralle H, Elisei R, Smit JWA, Wiersinga W, The European Thyroid Cancer Taskforce (2006) European consensus for management of patients with differentiated thyroid carcinoma. Eur J Endocrinol 154:787–803CrossRefPubMedGoogle Scholar
  2. 2.
    Lundgren CI, Zedenius J, Skoog L (2008) Fine-needle aspiration biopsy of benign thyroid nodules: an evidence-based review. World J Surg 32:1247–1252CrossRefPubMedGoogle Scholar
  3. 3.
    Mazzaferri EL, Sipos J (2008) Should all patients with subcentimeter thyroid nodules undergo fine-needle aspiration biopsy and preoperative neck ultrasonography to define the extent of tumor invasion? Thyroid 18(6):597–602CrossRefPubMedGoogle Scholar
  4. 4.
    Gharib H, Goellner JR (1993) Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann of Int Med 118:282–289Google Scholar
  5. 5.
    Noordzij JP, Goto MM (2005) Airway compromise caused by hematoma after thyroid fine needle aspiration. Am J Otolaryngol 26(6):398–399CrossRefPubMedGoogle Scholar
  6. 6.
    Roh JL (2006) Intrathyroid hemorrage and acute upper airway obstruction after fine needle aspiration of the thyroid gland. Laryngoscope 116(1):154–156CrossRefPubMedGoogle Scholar
  7. 7.
    Hor T, Lahiri SW (2008) Bilateral thyroid hematomas after fine-needle aspiration causing acute airway obstruction. Thyroid 18(5):491–492CrossRefGoogle Scholar
  8. 8.
    Park MH, Yoon JH (2009) Anterior neck hematoma causing airway compression following fine needle aspiration cytology of the thyroid nodule: a case report. Acta Cytol 53(1):86–88PubMedGoogle Scholar
  9. 9.
    Rosenbaum MA, Haridas M, McHenry CR (2008) Life-threatening neck hematoma complicating thyroid and parathyroid surgery. Am J Surg 195:339–343CrossRefPubMedGoogle Scholar
  10. 10.
    Saylam B, Comcali B, Ozer MV, Coskun F (2009) Thyroid gland hematoma after blunt neck trauma. West J Emerg Med 10(4):247–249PubMedGoogle Scholar
  11. 11.
    Gursoy A, Ertugrul DT, Sahin M, Tutuncu NB, Demirer AN, Demirag NG (2007) Needle-free delivery of lidocaine for reducing the pain associated with the fine-needle aspiration biopsy of thyroid nodules: time-saving and efficacious procedure. Thyroid 17(4):317–321CrossRefPubMedGoogle Scholar
  12. 12.
    Kim DW, Rho MH, Kim KN (2009) Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules: is it necessary to use local anesthesia for the application of one needle puncture? Korean J Radiol 10(5):441–446CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Unit of General SurgeryHospital of MassaMassaItaly
  2. 2.BuggianoItaly

Personalised recommendations