Role of Neck Ultrasonography in the Follow-up of Patients Operated on for Thyroid Cancer

Abstract

The aim of the study was to evaluate the role of neck ultrasonography in follow-up of patients with differentiated thyroid cancer. Sixty-three patients had total thyroidectomy and 131I ablation for differentiated thyroid cancer and had a negative whole body scan during follow-up. They were admitted for a high resolution neck ultrasound examination. Sixteen of 63 patients presented images suspicious for lymph node metastasis and/or for local recurrences (4 cases). Fine needle aspiration confirmed the suspicion of malignancy in 12 patients: only lymph node metastasis in 8 cases, local recurrence and lymph node metastasis in 3 cases, and in one case only local recurrence. Fine needle aspiration was suspicious for lymphadenitis in 4 cases. Thyroglobulin levels were very high in all patients with local recurrence and/or lymph node metastasis but undetectable in 2 cases presenting node metastasis and in 4 cases with lymphadenitis. All but one patient were admitted for surgery and the cytological diagnosis was confirmed. Early identification of a pathologic mass in the neck is a desirable goal; high resolution echography can play an important role in the follow-up of these patients and can detect local recurrences even when there is a negative whole body scan or undetectable thyroglobulin level.

Optimal surgical procedure for locally curative surgery in patients with anaplastic thyroid carcinoma: importance of preoperative ultrasonography

“…Lymph node metastasis was diagnosed on ultrasonography based on the criteria by Antonelli et al [10]. Distant metastasis was evaluated at the time of diagnosis as ATC on CT scan.…”

Increased serum CXCL10 in Graves’ disease or autoimmune thyroiditis is not associated with hyper- or hypothyroidism per se, but is specifically sustained by the autoimmune, inflammatory process

“…The presence of hypoechoic and dyshomogeneous echogenicity was arbitrarily rated at three levels (0 ¼ normal echogenicity; 1 ¼ slight hypoechoic and dyshomogeneous; 2 ¼ severely hypoechoic and dyshomogeneous) to evaluate structural abnormalities of thyroid tissue associated with thyroid autoimmunity (18,19). The presence of thyroid nodules was recorded, and nodules with a diameter over 10 mm were submitted to ultrasonography-guided FNA, which was performed by the same operator, using the free-hand method, as previously described (17,19).…”

Use of preoperative ultrasonography as guidance for neck dissection in patients with papillary thyroid carcinoma

“…In patients with thyroid cancer, US can detect loco-regional metastatic disease as small as 2-3 mm in diameter [11,12], thus enabling the detection of metastatic lymph nodes missed by palpation alone in a significant proportion of patients with small macroscopic metastases [13]. Thus, preoperative US staging of the neck may lead to proper surgical management of patients with thyroid cancers [6,[13][14][15].…”