The Journal of laryngology and otology · 2012
A false aneurysm.
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Mitchell D, Repanos C, Coman W B
Аннотация
OBJECTIVE: We report a case of a remaining hemi-thyroid following laryngectomy, which was misinterpreted as a pseudoaneurysm.
METHODS: Case report and comment on this understandable error which is easily avoidable.
RESULTS: A 59-year-old man had undergone salvage laryngectomy for recurrent squamous cell carcinoma of the larynx, which had previously been treated with radiotherapy. Three months after his laryngectomy, he presented with a sore neck and subcutaneous collections. Computed tomography revealed a unilateral mass with high signal contrast uptake anterior to the left common carotid artery, which was thought initially to be a carotid pseudoaneurysm. Further investigation, including ultrasonography and a review by the senior head and neck radiologist, demonstrated that this mass was actually the remnant hemi-thyroid preserved at laryngectomy (which is often misshapen compared with a normal hemi-thyroid). The collections were found to be recurrent tumour, and unnecessary further interventions were avoided.
CONCLUSION: Ultrasonography easily distinguishes between a thyroid remnant and a pseudoaneurysm. Furthermore, the opinion of an experienced head and neck radiologist may be vital when interpreting complex post-surgical head and neck radiology.
METHODS: Case report and comment on this understandable error which is easily avoidable.
RESULTS: A 59-year-old man had undergone salvage laryngectomy for recurrent squamous cell carcinoma of the larynx, which had previously been treated with radiotherapy. Three months after his laryngectomy, he presented with a sore neck and subcutaneous collections. Computed tomography revealed a unilateral mass with high signal contrast uptake anterior to the left common carotid artery, which was thought initially to be a carotid pseudoaneurysm. Further investigation, including ultrasonography and a review by the senior head and neck radiologist, demonstrated that this mass was actually the remnant hemi-thyroid preserved at laryngectomy (which is often misshapen compared with a normal hemi-thyroid). The collections were found to be recurrent tumour, and unnecessary further interventions were avoided.
CONCLUSION: Ultrasonography easily distinguishes between a thyroid remnant and a pseudoaneurysm. Furthermore, the opinion of an experienced head and neck radiologist may be vital when interpreting complex post-surgical head and neck radiology.
Предметные рубрики MeSH
Aneurysm, FalseCarcinoma, Squamous CellCarotid Artery, InternalDiagnosis, DifferentialExudates and TransudatesFalse Positive ReactionsHumansLaryngeal NeoplasmsLaryngectomyMaleMiddle AgedNeckNeck DissectionNeck PainNeoplasm Recurrence, LocalPostoperative CareRadiographySalvage TherapyThyroid GlandThyroidectomyUltrasonography