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Preoperative Ultrasound-Guided Tattooing Localization of Recurrences After Thyroidectomy: Safety and Effectiveness

  • Endocrine Tumors
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The incidence of nonpalpable recurrence detected on follow-up ultrasound (US) after thyroidectomy has increased. However, surgical approach for nonpalpable lesions can be difficult. We assessed the safety and effectiveness of ultrasound-guided tattooing (US-tattoo) with a charcoal suspension for localizing nonpalpable cervical recurrences after thyroidectomy for thyroid cancer.

Methods

Between March 2004 and February 2008, we retrospectively assessed 55 consecutive patients with 83 lesions who underwent US-tattoo with injection of a charcoal suspension for nonpalpable lesions. All patients underwent the surgical dissection after US-tattoo. The complications and effectiveness of US-tattoo were evaluated using ultrasonographic, surgical, and pathologic records.

Results

Among 83 lesions, 72 recurrences and 11 benign lesions were confirmed by final pathology. The average size of the localized lesions was 0.7 cm (range 0.4–1.4 cm). The most common site of tattooing was cervical lymph nodes at level IV. The technical success rate of US-tattoo for suspicious lesions was 96% (80/83). Failure of US-tattoo occurred in lesions located posterior to major vessels. During surgery, all but two successful tattooed lesions were detected by surgeons. No residual lesion was detected at follow-up US. With regard to complications, two patients (4%) had a dot-like marking at the skin puncture site after US-tattoo.

Conclusion

Preoperative US-tattoo is a safe and effective method for successful reoperation of nonpalpable recurrences after thyroidectomy.

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Authors and Affiliations

  1. Departments of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-gu, Seoul, Republic of Korea

    Tae Wook Kang MD, Jung Hee Shin MD, Boo-Kyung Han MD, Eun Young Ko MD, Seok Seon Kang MD & Soo Yeon Hahn MD

  2. Departments of General Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Ji Soo Kim MD

  3. Departments of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Young Lyun Oh MD

Authors
  1. Tae Wook Kang MD
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  2. Jung Hee Shin MD
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  3. Boo-Kyung Han MD
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  4. Eun Young Ko MD
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  5. Seok Seon Kang MD
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  6. Soo Yeon Hahn MD
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  7. Ji Soo Kim MD
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  8. Young Lyun Oh MD
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Corresponding author

Correspondence to Jung Hee Shin MD.

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Kang, T.W., Shin, J.H., Han, BK. et al. Preoperative Ultrasound-Guided Tattooing Localization of Recurrences After Thyroidectomy: Safety and Effectiveness. Ann Surg Oncol 16, 1655–1659 (2009). https://doi.org/10.1245/s10434-009-0431-7

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  • DOI: https://doi.org/10.1245/s10434-009-0431-7

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