Extracapsular Cervical Hematoma After Thyroid Fine-Needle Aspiration Cytology

Abstract

Fine-needle aspiration cytology (FNAC) is a safe and well-tolerated procedure with high sensitivity and specificity. Serious complications, such as large hematomas, are very rare and should be promptly identified. We present an unusual case of a 71-year-old woman with a massive cervical hematoma that developed near thethyroid capsule after the FNAC of a nodule. CT showed a hematoma measuring 38 x 34 mm, causing deviation of the laryngotracheal axis. The patient was admitted to the intensive care unit for intubation and surgical drainage. This case illustrates that FNAC, despite being considered a safe procedure with infrequent complications, carries the risk of acute life-threatening events that should be taken into account.

Superior thyroid artery – variations of origin and clinical significance

“…Cases have been reported of severe haemorrhage or haematoma occurring after thyroidectomy [18][19][20], as well as after blunt neck trauma [21], which may be linked to variations of the STA. Haematomas and bleeding from this vessel could also be associated with procedures such as fine-needle aspiration of thyroid nodules [22,23], carotid artery stenting [24], and internal jugular vein catheterization [25]. Physicians performing these procedures should therefore be very familiar with the course of the STA, and possible variations in its origin.…”