Hook needle-guided excision of recurrent differentiated thyroid cancer in previously operated neck compartments

A safe technique for small, nonpalpable recurrent disease

Frederic Triponez, Liina Poder, Rasa Zarnegar, Ruth Goldstein, Kayvan Roayaie, Vickie Feldstein, James Lee, Electron Kebebew, Quan Yang Duh, Orlo H. Clark

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Context: As a result of more sensitive techniques to detect recurrent thyroid cancer, the number of patients presenting with small, nonpalpable recurrent thyroid cancer in cervical lymph nodes is increasing. Surgical excision of nonpalpable recurrent thyroid cancer can be difficult, particularly in a previously operated area. Objective: The objective of this study was to investigate whether preoperative insertion of a hook needle under ultrasound guidance is useful in neck reoperations for recurrent thyroid cancer. Patients: Ten consecutive patients presenting over a 4-month period with nonpalpable, ultrasound-visible, fine needle biopsy-proven recurrent thyroid cancer in previously operated neck compartment(s) were studied. Main Outcome Measures: We measured whether it was technically possible to insert a hook needle preoperatively, rate of negative neck exploration, and complication rate. Results: The hook needle was inserted in seven patients. In three patients, the hook needle was not inserted; one patient had palpable disease 4 months after the preoperative clinic visit, one patient had a tumor too close to the carotid artery, and one patient had multiple bilateral foci of recurrent disease in the central neck. One patient had bleeding after insertion of the needle due to a penetration of an anterior jugular vein that was easily managed at neck reexploration. No other complication occurred during the hook needle insertion, and the only surgical complication was a transient recurrent nerve palsy. All pathology reports showed malignant disease. Conclusion: Hook needle-guided excision of recurrent thyroid cancer is feasible and appears to be a promising tool for safe and successful reoperation of patients with small recurrent thyroid cancer in cervical lymph nodes.

Original languageEnglish (US)
Pages (from-to)4943-4947
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume91
Issue number12
DOIs
StatePublished - Dec 2006
Externally publishedYes

Fingerprint

Hooks
Thyroid Neoplasms
Needles
Neck
Reoperation
Ultrasonics
Lymph Nodes
Biopsy
Pathology
Jugular Veins
Tumors
Ambulatory Care
Fine Needle Biopsy
Carotid Arteries
Paralysis
Outcome Assessment (Health Care)
Hemorrhage

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Hook needle-guided excision of recurrent differentiated thyroid cancer in previously operated neck compartments : A safe technique for small, nonpalpable recurrent disease. / Triponez, Frederic; Poder, Liina; Zarnegar, Rasa; Goldstein, Ruth; Roayaie, Kayvan; Feldstein, Vickie; Lee, James; Kebebew, Electron; Duh, Quan Yang; Clark, Orlo H.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 91, No. 12, 12.2006, p. 4943-4947.

Research output: Contribution to journalArticle

Triponez, Frederic ; Poder, Liina ; Zarnegar, Rasa ; Goldstein, Ruth ; Roayaie, Kayvan ; Feldstein, Vickie ; Lee, James ; Kebebew, Electron ; Duh, Quan Yang ; Clark, Orlo H. / Hook needle-guided excision of recurrent differentiated thyroid cancer in previously operated neck compartments : A safe technique for small, nonpalpable recurrent disease. In: Journal of Clinical Endocrinology and Metabolism. 2006 ; Vol. 91, No. 12. pp. 4943-4947.
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