Lorenzo Fregoli1, Sohail Bakkar2, Piermarco Papini1, Liborio Torregrossa1, Clara Ugolini1, Leonardo Rossi1, Antonio Matrone3, Rossella Elisei4, Gabriele Materazzi5. 1. Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy. 2. Department of Surgery, Faculty of Medicine, Hashemite University, Zarqa 13133, Jordan. 3. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. 4. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: rossella.elisei@unipi.it. 5. Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy. Electronic address: gabriele.materazzi@unipi.it.
Abstract
BACKGROUND: Robot-assisted transaxillary thyroidectomy is a well-established remote-access thyroid procedure that has been demonstrated to be as safe and effective as its time-honored conventional clamp-and-tie counterpart. However, it has been incriminated for a set of unprecedented complications that surgeons need to be aware of and deal with appropriately. PATIENT FINDINGS: The patient is a young woman who underwent robot-assisted thyroid lobectomy for a sizeable nodule that was reported as benign after fine-needle aspiration cytology. She presented 3 years later with subcutaneous nodules along the surgical track that were found to represent seeding of benign thyroid tissue. This is the first report of benign thyroid tissue seeding after a gasless transaxillary procedure. SUMMARY: Seeding along the surgical track is a potential complication of gasless remote-access thyroid surgery, even in case of benign disease, that surgeons need to be acquainted with. CONCLUSIONS: Surgeons should be aware of the potential for benign seeding after remote-access thyroid procedures. Accordingly, adequate precautions should be taken, patients should be counseled in this regard, and alternative medical strategies to control local seeding of thyroid tissue could be suggested.
BACKGROUND: Robot-assisted transaxillary thyroidectomy is a well-established remote-access thyroid procedure that has been demonstrated to be as safe and effective as its time-honored conventional clamp-and-tie counterpart. However, it has been incriminated for a set of unprecedented complications that surgeons need to be aware of and deal with appropriately. PATIENT FINDINGS: The patient is a young woman who underwent robot-assisted thyroid lobectomy for a sizeable nodule that was reported as benign after fine-needle aspiration cytology. She presented 3 years later with subcutaneous nodules along the surgical track that were found to represent seeding of benign thyroid tissue. This is the first report of benign thyroid tissue seeding after a gasless transaxillary procedure. SUMMARY: Seeding along the surgical track is a potential complication of gasless remote-access thyroid surgery, even in case of benign disease, that surgeons need to be acquainted with. CONCLUSIONS: Surgeons should be aware of the potential for benign seeding after remote-access thyroid procedures. Accordingly, adequate precautions should be taken, patients should be counseled in this regard, and alternative medical strategies to control local seeding of thyroid tissue could be suggested.