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

Langenbeck's Archives of Surgery
Gianluca Donatini, Tiziano Masoni

Abstract

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. We report a series of three emergency cervicotomies for a massive neck hematoma causing acute respiratory distress after a thyroid FNAC. 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 lymphadenectomy was performed in the third case. Extubation was achieved within 12 h in the ICU. All patients were discharged uneventfully within 72 h. 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.

References

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Citations

Aug 17, 2010·Langenbeck's Archives of Surgery·Bruno Niederle
Jul 8, 2015·Thyroid : Official Journal of the American Thyroid Association·Pedro Weslley Rosário, Maria Regina Calsolari
Sep 27, 2019·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Marcello CovinoFrancesco Franceschi

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