Endosonographic examination of thyroid gland among patients with nonthyroid cancers.
OBJECTIVE
There is limited endosonographic literature regarding thyroid gland pathology, which is frequently visualized during upper endoscopic ultrasound (EUS). Our objective was to assess the prevalence of benign and malignant thyroid lesions encountered during routine upper EUS within a cancer center setting.


METHODS
The data were prospectively collected and retrospectively analyzed. All upper EUS procedures performed between October 2012 and July 2014 were reviewed at a large referral cancer center. Data collected included patient demographics, preexisting thyroid conditions, thyroid gland dimensions, the presence or absence of thyroid lesions, and EUS morphology of lesions if present, and interventions performed to characterize thyroid lesions and pathology results when applicable.


RESULTS
Two hundred and forty-five EUS procedures were reviewed. Of these, 100 cases reported a detailed endosonographic examination of the thyroid gland. Most of the thyroid glands were endosonographically visualized when the tip of the scope was at 18 cm from the incisors. Twelve cases showed thyroid lesions, out of which three previously undiagnosed thyroid cancers were visualized during EUS (two primary papillary thyroid cancers and one anaplastic thyroid cancer). Transesophageal EUS-guided fine needle aspiration of thyroid lesions was feasible when the lesion was in the inferior portion of the thyroid gland, and the tip of the scope was at 18 cm or more from the incisors.


CONCLUSIONS
Routine EUS examination may detect unexpected thyroid lesions including malignant ones. We encourage endosonographers to screen the visualized portions of the thyroid gland during routine withdrawal of the echoendoscope.
Southwestern Regional Medical Center, Cancer Treatment Centers of America, Tulsa, OK, USA; Department of Gastroenterology, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
Amer A
AA
Alkhatib
Southwestern Regional Medical Center, Cancer Treatment Centers of America, Tulsa, OK, USA.
Abdulah A
AA
Mahayni
Southwestern Regional Medical Center, Cancer Treatment Centers of America, Tulsa, OK, USA.
Ghaleb R
GR
Chawki
Southwestern Regional Medical Center, Cancer Treatment Centers of America, Tulsa, OK, USA.
Leon
L
Yoder
Division of Endocrinology, INTEGRIS Southwest Medical Center, OKC, OK, USA.
Fateh A
FA
Elkhatib
Department of Gastroenterology, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
Mohammad
M
Al-Haddad
Cancer; endoscopic ultrasound; endoscopic ultrasound-guided fine needle aspiration; fine needle aspiration; thyroid