Subcutaneous implantation of nodular goiter after endoscopic thyroidectomy: a case report

Abstract

Background Nodular goiter is a common benign tumor in clinical practice, it refers to a simple diffuse goiter due to repeated progression, causing follicular epithelium to diffuse into focal hyperplasia and degeneration in parts. Finally, because of long-term hyperplastic lesions and degenerative diseases, alternately repeatedly gland nodules in different stages of development, which is essentially a benign lesion and there are few reports confirming metastasis. Case presentation: The patient was a 26-year-old female with a history of right lobe subtotal thyroidectomy for thyroid nodules one year prior. Postoperative pathological examination revealed a nodular goiter with cystic changes in the "right lobe thyroid tumor". This time, she was admitted to the hospital because of the discovery of bilateral neck mass for one month. Physical examination: multiple protruding masses were seen in the neck, and the largest mass was located on the right side of the neck with a length of about 2 cm. Ultrasound showed multiple isoechoic nodules were found bilaterally in the neck, most of which were located in the sternocleidomastoid muscle. CT scan of the neck showed multiple nodules below the right lobe of the thyroid and in the front of the neck, and thyroid implantation lesions were considered. During the last operation, it was confirmed that the mass was scattered and mostly not in the area of the previous operation, and the pathological diagnosis was consistent with nodular goiter.It is thought to be caused by distant metastasis of a benign tumour and this is a very rare case. Conclusions This case report suggests that nodular goiter, as a benign lesion, may also present with implantation or metastasis, which should be considered in clinical practice, Surgeons need to prevent nodular goiter implantation during surgery.