Needle tract sinus following aspiration biopsy of papillary thyroid carcinoma: a case report.
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.
Basu
Adhish
A
Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. adhishbasu@rediffmail.com
Sistla
Sarath C
SC
Siddaraju
Neelaiah
N
Verma
Surendra Kumar
SK
Iyengar
Krishnan R
KR
Jagdish
Sadasivam
S
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
D013974:Thyroxine