Needle tract sinus following aspiration biopsy of papillary thyroid carcinoma: a case report

• Published in: Acta cytologica Vol. 52; no. 2; p. 211
• Main Authors: Basu, Adhish, Sistla, Sarath C, Siddaraju, Neelaiah, Verma, Surendra Kumar, Iyengar, Krishnan R, Jagdish, Sadasivam
• Format: Journal Article
• Language: English
• Published: Switzerland 01.03.2008
• Subjects: Biopsy, Fine-Needle - adverse effects; Carcinoma, Papillary - pathology; Carcinoma, Papillary - therapy; Female; Goiter - pathology; Goiter - therapy; Humans; Middle Aged; Neoplasm Seeding; Radiotherapy, Adjuvant; Skin Diseases - etiology; Skin Diseases - pathology; Thyroid Neoplasms - pathology; Thyroid Neoplasms - therapy; Thyroid Nodule - pathology; Thyroid Nodule - therapy; Thyroidectomy; Thyroxine - therapeutic use; Treatment Outcome
• ISSN: 0001-5547
• DOI: 10.1159/000325483

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. 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. 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.