title: A systematic review of cases reporting needle tract seeding following thyroid fine needle biopsy.
abstract: BACKGROUND
  Because of its accuracy and cost-effectiveness, thyroid fine needle biopsy (FNB) is the procedure of choice in the preoperative management of thyroid nodules. Needle tract seeding (NTS) has been a concern since the earliest days of FNB, contributing to the delayed acceptance of FNB as a safe procedure. In this review we tried to systematically record all reports of NTS after diagnostic thyroid FNB and provide useful hints to minimize the risk of NTS.
  
  
  METHODS
  Computerized advanced search for primary evidence was performed in the PubMed (Public/Publisher Medline) electronic database. The search was not limited by publication time or English language.
  
  
  RESULTS
  Ten relevant articles were found: eight case reports, one case in a surgical series, and one retrospective observational study.
  
  
  CONCLUSIONS
  Despite initial concerns about the risk of NTS, FNB is now considered to be a safe procedure. Although proper FNB technique can reduce its risk, NTS is an unavoidable complication of FNB, which clinicians should be aware of. However, the incidence of NTS is low and it doesn't seem to affect the prognosis because the seedings can be surgically removed without recurrence. The management of the thyroid nodules is to-date based on FNB, and the benefits from FNB (elimination of needless imaging and surgery) far outweigh the potential risk for NTS.
authors.affiliation: Second Medical Clinic, Medical School, Aristotle University of Thessaloniki, Ippokration Hospital, 546 42, Thessaloniki, Greece. stergios@endo.gr
authors.forename: Stergios A
authors.initials: SA
authors.lastname: Polyzos
authors.forename: Athanasios D
authors.initials: AD
authors.lastname: Anastasilakis
mesh_terms: D044963:Biopsy, Fine-Needle / Q000009:adverse effects*; D006801:Humans; D009366:Neoplasm Seeding; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology