Sonographic features of traumatic neuromas after neck dissection

Area of Science:

• Medical Imaging
• Oncology
• Pathology

Background:

• Neck dissection can lead to iatrogenic injuries, potentially causing traumatic neuromas.
• Traumatic neuromas are often asymptomatic and incidentally detected during imaging for other conditions.
• Accurate diagnosis of traumatic neuromas is crucial to differentiate them from recurrent malignancies.

Purpose of the Study:

• To characterize the sonographic features of traumatic neuromas.
• To identify key diagnostic indicators for traumatic neuromas in the neck region.
• To evaluate the utility of ultrasound in diagnosing post-dissection traumatic neuromas.

Main Methods:

• Retrospective review of sonograms and medical records from 8 patients.
• Patients underwent neck sonography for suspected thyroid cancer recurrence.
• Diagnosis was confirmed by clinical, laboratory, fine-needle aspiration biopsy (FNAB), and other imaging modalities.

Main Results:

• Traumatic neuromas were incidentally detected in 8 patients during neck sonography.
• Characteristic sonographic finding: isoechoic mass with internal parallel heterogeneous hyperechogenicity.
• Patients experienced severe pain during FNAB; cytological results showed nerve tissue in 2 cases.
• Low thyroglobulin (Tg) levels (<0.2 ng/mL) in FNAB washout fluid indicated a nonthyroidal origin.

Conclusions:

• Distinctive sonographic features can suggest traumatic neuromas.
• Sharp pain during FNAB and low Tg levels in washout fluid are valuable diagnostic clues.
• Non-invasive diagnosis of traumatic neuromas is achievable, potentially avoiding surgical intervention.