Multifocal Hot Spots Demonstrated by Whole-Body 131I Scintigraphy and SPECT/CT After Transaxillary Endoscopic Thyroidectomy

131 I Accumulation Due to an Intrauterine Device in a Papillary Thyroid Carcinoma Patient

ABSTRACT

A 46-year-old woman underwent 131 I radiotherapy following thyroidectomy for papillary thyroid carcinoma. Posttherapeutic 131 I scintigraphy was performed 4 days later. Both attenuation-corrected and non-attenuation-corrected 131 I tomography images elucidated an intrauterine device with avid 131 I uptake in her uterus. This case illustrated that an intrauterine device should be considered as a potential cause of false-positive results in posttherapeutic 131 I scintigraphy, highlighting the need for accurate image interpretation to avoid unnecessary treatment.

Track recurrence after remote-access thyroid surgeries: A systematic review

BACKGROUND

Remote-access thyroidectomies have gained popularity, but track recurrence, which is the implantation of thyroid tissue or lesions along the surgical access route, has been reported in case studies. This systematic review aims to review cases of track recurrence following remote-access thyroidectomies.

METHODS

A comprehensive literature search was conducted using PubMed, the Web of Science, the Cochrane Library, and Google Scholar to identify case reports on track recurrence after endoscopic or robotic thyroidectomy up to June 2024. Data included patient demographics, details of the initial surgery and diagnosis, methods and timing of recurrence detection, and management strategies.

RESULTS

The search yielded 1578 articles, of which 17 case reports comprising 18 patients were included. The patients (16 females and two males) had a mean age of 34.6 ± 14.9 years. The mean size of initial tumors was 3.9 ± 1.2 cm, with diagnoses of eight cancers and 10 benign lesions. The initial surgeries included 12 endoscopic and six robotic procedures. Track recurrence was most often detected by palpable nodules followed by routine imaging and elevated serum Tg levels. The interval between initial surgery and recurrence ranged from 3 months to 8 years. Management varied from surgical resection and radioactive iodine therapy to close observation. There were no further recurrences in all but one case postoperatively.

CONCLUSION

Track recurrence after remote-access thyroidectomy is rare but significant. Proper surgical techniques, careful handling of thyroid tissue, and rigorous postoperative monitoring are essential to minimize this risk. Awareness and prompt management of track recurrence may lead to favorable outcomes.

False-Positive 131I Uptake After Transareola Endoscopic Thyroidectomy in a Patient With Papillary Thyroid Carcinoma

ABSTRACT

False-positive 131I accumulation in patients with thyroid carcinoma could be due to various etiologies. Herein, we reported a case of papillary thyroid carcinoma in a 36-year-old woman. She underwent a 131I radiotherapy after a transareola endoscopic total thyroidectomy. 131I scintigraphy showed a high uptake in the thyroid bed. Surprisingly, increased activity was also noted in the right areola area. This activity corresponding to the entry site of endoscope revealed on the following SPECT/CT.

First report of benign track seeding after robot-assisted transaxillary thyroid surgery

BACKGROUND

Robot-assisted transaxillary thyroidectomy is a well-established remote-access thyroid procedure that has been demonstrated to be as safe and effective as its time-honored conventional clamp-and-tie counterpart. However, it has been incriminated for a set of unprecedented complications that surgeons need to be aware of and deal with appropriately.

PATIENT FINDINGS

The patient is a young woman who underwent robot-assisted thyroid lobectomy for a sizeable nodule that was reported as benign after fine-needle aspiration cytology. She presented 3 years later with subcutaneous nodules along the surgical track that were found to represent seeding of benign thyroid tissue. This is the first report of benign thyroid tissue seeding after a gasless transaxillary procedure.

SUMMARY

Seeding along the surgical track is a potential complication of gasless remote-access thyroid surgery, even in case of benign disease, that surgeons need to be acquainted with.

CONCLUSIONS

Surgeons should be aware of the potential for benign seeding after remote-access thyroid procedures. Accordingly, adequate precautions should be taken, patients should be counseled in this regard, and alternative medical strategies to control local seeding of thyroid tissue could be suggested.

Port-Site Implantation Diagnosed by Iodine-131 Post-Ablation Single-Photon Emission Tomography-Computed Tomography After Robotic Thyroidectomy: A Case Report

Patient: Female, 37

Final Diagnosis: Port-site implantation after robotic thyroidectomy

Symptoms: None

Medication: —

Clinical Procedure: Iodine-131 post-ablation whole body scan and single photon emission tomography-computed tomography

Specialty: Nuclear Medicine

Quality of life and cosmetic result of single-port access endoscopic thyroidectomy via axillary approach in patients with papillary thyroid carcinoma

BACKGROUND

Endoscopic thyroidectomy for minimally invasive thyroid surgery has been widely applied in the past decade. The present study aimed to evaluate the effects of single-port access transaxillary totally endoscopic thyroidectomy on the postoperative outcomes and functional parameters, including quality of life and cosmetic result in patients with papillary thyroid carcinoma (PTC).

PATIENTS AND METHODS

Seventy-five patients with PTC who underwent endoscopic thyroidectomy via a single-port access transaxillary approach were included (experimental group). A total of 123 patients with PTC who were subjected to conventional open total thyroidectomy served as the control group. The health-related quality of life and cosmetic and satisfaction outcomes were assessed postoperatively.

RESULTS

The mean operation time was significantly increased in the experimental group. The physiological functions and social functions in the two groups were remarkably augmented after 6 months of surgery. However, there was no significant difference in the scores of speech and taste between the two groups at the indicated time of 1 month and 6 months. In addition, the scores for appearance, satisfaction with appearance, role-physical, bodily pain, and general health in the experimental group were better than those in the control group at 1 month and 6 months after surgery.

CONCLUSION

The single-port access transaxillary totally endoscopic thyroidectomy is safe and feasible for the treatment of patients with PTC. The subjects who underwent this technique have a good perception of their general state of health and are likely to participate in social activities. It is worthy of being clinically used for patients with PTC.