Persistent metastatic thyroid carcinoma

• Main Authors: Ghobad Azizi, Michelle Lewis Mayo, Yasmin Azizi, James Keller, Carl Malchoff
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Journal of Medical Ultrasound
• Subjects: lymph node; shear wave elastography; thyroid carcinoma; thyroid nodule; ultrasound
• Online Access: http://www.jmuonline.org/article.asp?issn=0929-6441;year=2020;volume=28;issue=2;spage=111;epage=113;aulast=Azizi

The decision to biopsy small thyroid nodules (TNs) is controversial. Careful ultrasound (US) evaluation with shear wave elastography (SWE) of TN and cervical lymph nodes (LNs) may aid in the decision to biopsy and subsequently influence the extent of surgery. A 46-year-old female presented with TNs and hypothyroidism. Her target TN in the left lobe measured 4.8 mm × 4 mm × 4 mm. Fine needle aspiration biopsy of the left TN and a left neck level 6 LN was diagnostic for papillary thyroid carcinoma. In the left lateral neck posterior to the jugular vein, there was a LN with possible microcalcifications that could not be sampled due to vascular proximity. SWE examination showed high velocity suspicious for metastatic disease. In summary, risk stratification for small TNs and cervical LNs can be difficult. SWE can provide valuable information for assessing the risk for malignancy.