Radioguided occult lesion localization for locally recurrent thyroid carcinoma

The aim of this study was to present our experiences with patients operated on for the recurrence of papillary thyroid cancer with the combined use of preoperative ultrasonographic mapping and radioguided occult lesion localization (ROLL). Twenty patients who had already undergone total thyroidectomy and central/lateral neck dissection for papillary thyroid carcinoma were reoperated on due to locoregional metastasis. The patients with proven recurrences and high Tg wash-out levels in cytopathologic aspirates were operated on. For each patient, numbers of marked and non-marked lesions, and the metastatic and total numbers of marked/non-marked and non-mentioned lesions in the maps were recorded. Thirty-four of 40 (85%) lesions removed with ROLL were found to be malignant. In addition to the marked lesions during mapping, 60 additional lesions had been defined as suspicious. Fifty-six of these lesions were found at exact anatomic sites and localizations described and removed. Of 56 lesions, 36 (64%) were found to be metastatic. During postoperative follow-up, chylous leak with spontaneous regression in 7 days and seroma occurred in one patient. Radioguided occult lesion localization and preoperative mapping contribute to the safety and comfort of patients in planned reoperations on lateral and central neck regions.