ABSTRACT
BACKGROUND: 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. CASE: 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. CONCLUSION: 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.
Subject(s)
Biopsy, Fine-Needle/adverse effects , Carcinoma, Papillary/pathology , Goiter/pathology , Neoplasm Seeding , Skin Diseases/etiology , Thyroid Neoplasms/pathology , Thyroid Nodule/pathology , Carcinoma, Papillary/therapy , Female , Goiter/therapy , Humans , Middle Aged , Radiotherapy, Adjuvant , Skin Diseases/pathology , Thyroid Neoplasms/therapy , Thyroid Nodule/therapy , Thyroidectomy , Thyroxine/therapeutic use , Treatment OutcomeABSTRACT
We describe a unique case of congenital umbilicobiliary fistula. A full-term neonate presented with passage of bile through the umbilicus. A contrast study demonstrated communication with the intrahepatic biliary system.
