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An unusual case in endocrinology practice: Suture granuloma
Insights
Suture granuloma, a rare thyroidectomy complication, mimics cancer recurrence on imaging. Early recognition is key for accurate diagnosis and appropriate patient management.
Area of Science:
- Endocrinology
- Surgical Pathology
Background:
- Suture granuloma is a rare complication following thyroidectomy, often caused by nonabsorbable suture materials.
- It can mimic malignant conditions, necessitating careful differential diagnosis.
Observation:
- A 54-year-old female, post-thyroidectomy for multinodular goiter and incidental micropapillary carcinoma, presented with neck swelling four years later.
- Ultrasonography showed nodules with suspicious features, including calcifications and hyperechoic lines.
Findings:
- Fine needle aspiration biopsy confirmed suture granuloma in both the right and left neck masses.
- Cytological examination was crucial in differentiating it from recurrent thyroid cancer.
Implications:
- Suture granuloma diagnosis is critical for avoiding unnecessary treatments for suspected thyroid cancer recurrence.
- Awareness of this complication aids in accurate interpretation of post-thyroidectomy neck imaging and masses.
Objective:
Suture granuloma, the rare complication of thyroidectomy, results from the use of nonabsorbable suture materials. Despite its typical ultrasound images and benign course, it carries utmost importance in the diff erential diagnosis of lymph nodes, recurrent nodules, and recurrence in the case of thyroid cancers. Subject and Results. Fifty four years old female patient, who underwent bilateral thyroidectomy in July 2010, was diagnosed with multinodular goiter and incidentally discovered micropapillary carcinoma (2 mm). Four years later, she was readmitted to hospital due to painless swelling in the right and left anterior neck region. Ultrasonography revealed nodules with irregular boundaries, containing micro- and macro-calcifications and hyperechoic lines in both sides of the thyroid bed and isthmus. Fine needle aspiration biopsy was performed in the right and left sided mass and the cytological examination was compatible with the diagnosis of the suture granuloma.
Conclusions:
Suture granuloma should be considered in the differential diagnosis of the local recurrence.
