title: Identification of continuity of transected nerve on sonography after neck dissection: direct sign of traumatic neuroma.
abstract: BACKGROUND
  Traumatic neuroma can be confused with a metastatic lymph node after neck dissection for malignancy, thereby increasing patient anxiety and necessitating fine needle aspiration (FNA). To date, however, there have been no reports showing a direct ultrasonographic (US) sign of traumatic neuroma that could help distinguish it from a metastatic lymph node after neck dissection. Here, we describe a patient with traumatic neuroma who showed a direct US sign after total thyroidectomy with modified radical neck dissection (MRND).
  
  
  CONCLUSIONS
  A 61-year-old man who had undergone total thyroidectomy with bilateral MRND for papillary thyroid carcinoma was found to have an oval-shaped nodule in his right lateral neck by US examination, which was first suspected of being a metastatic lymph node. However, when the position of the US transducer was changed to the oblique plane, a thin, cord-like, hypoechoic structure was found to be connected to the nodule. This structure passed between the longus capitis and scalenus medius muscles in an upward direction, and was ultimately located in the groove of the right transverse process of the C4 vertebra. Based on this anatomic relation, we concluded that the nodule was a traumatic neuroma and did not perform an unnecessary FNA.
  
  
  CONCLUSIONS
  The detection of a mass in the line of the transected nerve may be a direct US indication of traumatic neuroma after neck dissection.
authors: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Korea.
authors: Eun Ju
authors: EJ
authors: Ha
authors: Jeong Hyun
authors: JH
authors: Lee
authors: Hyun Kyung
authors: HK
authors: Lim
authors: Won
authors: W
authors: Bae Kim
authors: Jung Hwan
authors: JH
authors: Baek
mesh_terms: D002277:Carcinoma; D002291:Carcinoma, Papillary; D002572:Cervical Plexus / Q000000981:diagnostic imaging* / Q000293:injuries; D003937:Diagnosis, Differential; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects*; D009463:Neuroma / Q000000981:diagnostic imaging* / Q000209:etiology; D059348:Peripheral Nerve Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D011237:Predictive Value of Tests; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography