Magnetic Probe-Guided Excision of Nonpalpable Neck Lesions.
BACKGROUND
Reoperative neck surgery is technically more demanding because of the presence of scar tissue and distorted anatomy. We aimed to investigate the magnetic probe-guided excision of nonpalpable neck lesions in patients with previously operated neck compartments.


METHODS
This study included 9 patients with recurrent/persistent thyroid carcinoma, recurrent/persistent hyperparathyroidism with previously operated neck compartments. The pathologic lesions were localized by ultrasonography, and magnetic tracer (0.2 mL, iron oxide) was injected directly into the pathologic lesions. Careful dissection was carried out following the area of maximum magnetic activity until the nonpalpable lesions were identified and excised.


RESULTS
All neck lesions were removed in 9 patients. The median count from lesion was significantly higher than values from lesion bed (background activity; (9900/5 seconds vs 250/5 seconds, P < .001). During follow-up, all patients had negative ultrasonography.


CONCLUSIONS
Magnetic probe-guided technique could provide access to nonpalpable lesion localization in centers without readily available access to nuclear medicine facilities.
1 Istanbul University, Istanbul, Turkey.
Nihat
N
Aksakal
2 Biruni University, Istanbul, Turkey.
Alper
A
Ozturk
3 Kolan Hospital, Istanbul, Turkey.
Firat
F
Tutal
1 Istanbul University, Istanbul, Turkey.
Selim
S
Dogan
4 Koc University, Istanbul, Turkey.
Orhan
O
Agcaoglu
1 Istanbul University, Istanbul, Turkey.
Mesut
M
Bulakci
1 Istanbul University, Istanbul, Turkey.
Umut
U
Barbaros
5 Erbil Endocrine, Istanbul, Turkey.
Yesim
Y
Erbil
D000293:Adolescent; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005290:Ferric Compounds; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D014463:Ultrasonography
D005290:Ferric Compounds; C000499:ferric oxide
magnetic probe–guided excision; metastatic lymph nodes; papillary thyroid cancer; reoperation