Document Detail

Combination of preoperative ultrasonographic mapping and radioguided occult lesion localization in patients with locally recurrent/persistent papillary thyroid carcinoma: a practical method for central compartment reoperations.
MedLine Citation:
PMID:  20940540     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To improve the surgical success and reduce the complication rates, we combine our routine preoperative ultrasound (US) mapping technique with radioguided occult lesion localization (ROLL) in patients with papillary thyroid cancer recurrences in central compartment.
MATERIALS AND METHODS: In the morning of surgery, biopsy proven recurrent/persistent tumoral lesions were plotted on a sketch and injected with Tc-99m labeled macroaggregated albumin under US guidance. Thyroid bed exploration was carried out based on the location of biopsy proven lesion with the guidance of intraoperative gamma probe and neck map. The lymphoadipose tissues showing high count rates were resected and labeled separately for histopathologic study.
RESULTS: Despite extensive scarring in some patients probe safely guided to lesions. Noninjected tumor foci were searched and successfully resected in the light of neck map that showing topographic relation of injected and noninjected lesions. Among total of 41 excised lesions, 28 metastatic foci ranging from 3 to 38 mm in largest diameter were recognized at final histologic examination. Combination of preoperative mapping with ROLL was found helpful by the operating surgeons in all patients, respectively. Except 2 patients with known distant metastases, undetectable thyroglobulin levels were reached 6 weeks after surgery.
CONCLUSIONS: The use of preoperative US-mapping with ROLL in patients with nonpalpable recurrent/persistent papillary thyroid cancer in central compartment is technically safe and effective method. Combination of techniques provides better information about topographical relations of recurrent/persistent lesions during surgery.
Seyfettin Ilgan; Erkan Oztürk; Ramazan Yildiz; Ozdeş Emer; Asli Ayan; Semih Görgülü; Engin Alagöz; Salih Deveci; Mehmet Ali Ozgüven; Turgut Tufan
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  35     ISSN:  1536-0229     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-13     Completed Date:  2011-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  847-52     Citation Subset:  IM    
Department of Nuclear Medicine, Gülhane Military Medical Academy, Ankara, Turkey.
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MeSH Terms
Middle Aged
Neoplasm Recurrence, Local / surgery*,  ultrasonography*
Postoperative Complications
Preoperative Period*
Reoperation / adverse effects,  methods
Surgery, Computer-Assisted / adverse effects,  methods*
Thyroid Neoplasms / surgery,  ultrasonography
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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