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Asymptomatic intrathyroidal pyriform sinus fistula mimicking thyroid cancer: A case report and literature review.

Abstract There have been many reports of non-thyroidal lesions which can be mistaken for thyroidal lesions on ultrasound (US) examination. However, it is not known that pyriform sinus fistula (PSF) can manifest as an incidental thyroid nodule and cause serious complication on fine-needle aspiration (FNA).
PMID
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Authors

Mayor MeshTerms

Fistula

Pyriform Sinus

Retropharyngeal Abscess

Thyroid Gland

Keywords
Journal Title medicine
Publication Year Start




PMID- 29668629
OWN - NLM
STAT- MEDLINE
DCOM- 20180424
LR  - 20180503
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 16
DP  - 2018 Apr
TI  - Asymptomatic intrathyroidal pyriform sinus fistula mimicking thyroid cancer: A
      case report and literature review.
PG  - e0488
LID - 10.1097/MD.0000000000010488 [doi]
AB  - RATIONALE: There have been many reports of non-thyroidal lesions which can be
      mistaken for thyroidal lesions on ultrasound (US) examination. However, it is not
      known that pyriform sinus fistula (PSF) can manifest as an incidental thyroid
      nodule and cause serious complication on fine-needle aspiration (FNA). PATIENT
      CONCERNS: We present a 34-year-old man with PSF incidentally detected on US. US
      examination showed hypoechoic nodule with several bright echogenic spots at the
      uppermost part of left thyroid gland. With the suspicion of thyroid cancer,
      although there would have been some morphologic changes between the 2 US
      examinations, FNA was performed. DIAGNOSES: Cytologic specimen revealed some
      clusters of ciliated columnar cells mixed with inflammatory and lymphoid cells.
      On computed tomography (CT) before FNA, there were tiny air bubbles within the
      thyroid nodule. Laryngoscopy revealed fistula originating from the pyriform
      sinus. INTERVENTIONS: After FNA, he had to undergo tracheostomy and removal of
      abscess due to infectious complication. OUTCOMES: The deep neck abscesses and
      infections were controlled after the treatment. At 1 year after FNA, successful
      chemocauterization with 40% trichloracetic acid solution was performed for PSF
      found on laryngoscopy. LESSONS: PSF can manifest as an incidental thyroid nodule 
      mimicking thyroid cancer. Special care should be taken when FNA is planned for
      the nodule with air foci and morphologic changeability at the uppermost part of
      left thyroid gland.
FAU - Kim, Soo Chin
AU  - Kim SC
AD  - Department of Radiology, Seoul National University Hospital Healthcare System
      Gangnam Center.
FAU - Kim, Ji-Hoon
AU  - Kim JH
AD  - Department of Radiology.
FAU - Won, Jae-Kyung
AU  - Won JK
AD  - Department of Pathology.
FAU - Chung, Eun Jae
AU  - Chung EJ
AD  - Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National
      University Hospital, Seoul, Republic of Korea.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Caustics)
RN  - 5V2JDO056X (Trichloroacetic Acid)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Biopsy, Fine-Needle/*adverse effects/methods
MH  - Caustics/therapeutic use
MH  - Cautery/*methods
MH  - Diagnosis, Differential
MH  - Drainage/methods
MH  - *Fistula/diagnosis/therapy
MH  - Humans
MH  - Incidental Findings
MH  - Laryngoscopy/methods
MH  - Male
MH  - *Pyriform Sinus/diagnostic imaging/pathology
MH  - *Retropharyngeal Abscess/diagnosis/etiology/prevention & control/therapy
MH  - *Thyroid Gland/diagnostic imaging/pathology
MH  - Thyroid Neoplasms/*diagnosis
MH  - Tomography, X-Ray Computed/methods
MH  - Tracheostomy/methods
MH  - Treatment Outcome
MH  - Trichloroacetic Acid/administration & dosage
MH  - Ultrasonography/methods
PMC - PMC5916699
EDAT- 2018/04/19 06:00
MHDA- 2018/04/25 06:00
CRDT- 2018/04/19 06:00
PHST- 2018/04/19 06:00 [entrez]
PHST- 2018/04/19 06:00 [pubmed]
PHST- 2018/04/25 06:00 [medline]
AID - 10.1097/MD.0000000000010488 [doi]
AID - 00005792-201804200-00055 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Apr;97(16):e0488. doi: 10.1097/MD.0000000000010488.