title: Needle tract sinus following aspiration biopsy of papillary thyroid carcinoma: a case report.
abstract: BACKGROUND
  Fine needle aspiration biopsy (FNAB) of the thyroid is a simple and safe investigation. Dissemination of malignant cells during FNA for papillary thyroid carcinoma is extremely uncommon.
  
  
  METHODS
  We report a 49-year-old woman who presented with a multicystic goiter and palpable cervical lymph nodes. Three sessions of FNAB (a total of 12 needle passes) from a complex cyst overlying the thyroid isthmus using a 22-gauge needle failed to reveal malignant cells. Following the FNAs she developed a persistent discharging sinus at the needle insertion site. Exploration of the neck and histopathologic examination confirmed a well-differentiated papillary thyroid carcinoma infiltrating the skin and strap muscles at a single focus. Debulking surgery with adjuvant radiotherapy had a satisfactory outcome in our patient.
  
  
  CONCLUSIONS
  Skin sinus formation might have been prevented in our case by using a needle with a caliber < 22 gauge and avoiding multiple sessions of aspiration of the same thyroid nodule.
authors.affiliation: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. adhishbasu@rediffmail.com
authors.forename: Adhish
authors.initials: A
authors.lastname: Basu
authors.forename: Sarath C
authors.initials: SC
authors.lastname: Sistla
authors.forename: Neelaiah
authors.initials: N
authors.lastname: Siddaraju
authors.forename: Surendra Kumar
authors.initials: SK
authors.lastname: Verma
authors.forename: Krishnan R
authors.initials: KR
authors.lastname: Iyengar
authors.forename: Sadasivam
authors.initials: S
authors.lastname: Jagdish
mesh_terms: D044963:Biopsy, Fine-Needle / Q000009:adverse effects*; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000628:therapy; D005260:Female; D006042:Goiter / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D009366:Neoplasm Seeding; D018714:Radiotherapy, Adjuvant; D012871:Skin Diseases / Q000209:etiology* / Q000473:pathology; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000628:therapy; D016606:Thyroid Nodule / Q000473:pathology* / Q000628:therapy; D013965:Thyroidectomy; D013974:Thyroxine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013974:Thyroxine