Stergios A Polyzos1, Athanasios D Anastasilakis. 1. Second Medical Clinic, Medical School, Aristotle University of Thessaloniki, Ippokration Hospital, 546 42, Thessaloniki, Greece. stergios@endo.gr
Abstract
BACKGROUND: Because of its accuracy and cost-effectiveness, thyroid fine needle biopsy (FNB) is the procedure of choice in the preoperative management of thyroid nodules. Needle tract seeding (NTS) has been a concern since the earliest days of FNB, contributing to the delayed acceptance of FNB as a safe procedure. In this review we tried to systematically record all reports of NTS after diagnostic thyroid FNB and provide useful hints to minimize the risk of NTS. METHODS: Computerized advanced search for primary evidence was performed in the PubMed (Public/Publisher Medline) electronic database. The search was not limited by publication time or English language. RESULTS: Ten relevant articles were found: eight case reports, one case in a surgical series, and one retrospective observational study. CONCLUSIONS: Despite initial concerns about the risk of NTS, FNB is now considered to be a safe procedure. Although proper FNB technique can reduce its risk, NTS is an unavoidable complication of FNB, which clinicians should be aware of. However, the incidence of NTS is low and it doesn't seem to affect the prognosis because the seedings can be surgically removed without recurrence. The management of the thyroid nodules is to-date based on FNB, and the benefits from FNB (elimination of needless imaging and surgery) far outweigh the potential risk for NTS.
BACKGROUND: Because of its accuracy and cost-effectiveness, thyroid fine needle biopsy (FNB) is the procedure of choice in the preoperative management of thyroid nodules. Needle tract seeding (NTS) has been a concern since the earliest days of FNB, contributing to the delayed acceptance of FNB as a safe procedure. In this review we tried to systematically record all reports of NTS after diagnostic thyroid FNB and provide useful hints to minimize the risk of NTS. METHODS: Computerized advanced search for primary evidence was performed in the PubMed (Public/Publisher Medline) electronic database. The search was not limited by publication time or English language. RESULTS: Ten relevant articles were found: eight case reports, one case in a surgical series, and one retrospective observational study. CONCLUSIONS: Despite initial concerns about the risk of NTS, FNB is now considered to be a safe procedure. Although proper FNB technique can reduce its risk, NTS is an unavoidable complication of FNB, which clinicians should be aware of. However, the incidence of NTS is low and it doesn't seem to affect the prognosis because the seedings can be surgically removed without recurrence. The management of the thyroid nodules is to-date based on FNB, and the benefits from FNB (elimination of needless imaging and surgery) far outweigh the potential risk for NTS.
Authors: Hossein Gharib; Enrico Papini; Roberto Valcavi; H Jack Baskin; Anna Crescenzi; Massimo E Dottorini; Daniel S Duick; Rinaldo Guglielmi; Carlos Robert Hamilton; Martha A Zeiger; Michele Zini Journal: Endocr Pract Date: 2006 Jan-Feb Impact factor: 3.443
Authors: Henning Dralle; Thomas J Musholt; Jochen Schabram; Thomas Steinmüller; Andreja Frilling; Dietmar Simon; Peter E Goretzki; Bruno Niederle; Christian Scheuba; Thomas Clerici; Michael Hermann; Jochen Kußmann; Kerstin Lorenz; Christoph Nies; Peter Schabram; Arnold Trupka; Andreas Zielke; Wolfram Karges; Markus Luster; Kurt W Schmid; Dirk Vordermark; Hans-Joachim Schmoll; Reinhard Mühlenberg; Otmar Schober; Harald Rimmele; Andreas Machens Journal: Langenbecks Arch Surg Date: 2013-03-03 Impact factor: 3.445