Hypertrofic scar – associated ultrasound aspects after thyroidectomy

• Main Authors: Florica SANDRU, Ana VALEA, Simona Elena ALBU, Mihai Cristian DUMITRASCU, Mara CARSOTE
• Format: Article
• Language: English
• Published: Amaltea Medical Publishing House 2020-03-01
• Series: Romanian Journal of Medical Practice
• Subjects: hypertrophic scar; keloids; thyroidectomy
• Online Access: https://rjmp.com.ro/articles/2020.1/RJMP_2020_1_Art-22.pdf

Scar is part of wound healing and hypertrophic aspects as well as keloids are pathological formation of a scar. Their appearance is seen post-operatory, post-trauma and the consequences are more than cosmetic depending on location, for instance at joins functional impotence is associated. A scar formation involves activation of matrix enzymes, matrix response, local inflammation and fibroblast intervention as well as local cytokines and growth factors action. Our purpose is to introduce to cases of females who developed hypertrophic scars after thyroidectomy in addition to local swelling as revealed by neck ultrasound. The paper is two cases series report. The hormonal assays and ultrasound aspects are provided. A 30-year female with Basedow disease had one month after thyroidectmy TRAb of 2.4 U/l while TSH was 1 of under daily 100 µg of levothyroxine. The subject presented a post-operatory hypertrophic scar in addition to the following ultrasound aspect: right area with an inhomogeneous structure of 1/1.2/4 cm, left area of 1.4/1.7/4 cm, with multiple images with posterior echo and intense local edema. This is a 44–year female referred for total thyroidectomy (for large goiter). The subject did not develop any peri-operatory complication. The histological report showed chronic autoimmune thyoiditis background of focal type in addition to nodules of colloidal and cystic adenomatosis with hyperplasic epithelium. One month later TSH was normal under levothyroxine. The subject presented a post-operatory hypertrophic scar in addition to ultrasound aspect of edema in association with inflammatory lymph nodes at lateral cervical level of 0.6/0.2 cm maximum diameter. It is still a matter of debate to classify the high risk patients for developing post-thyroidectomy scars.