Post Thyroidectomy

[Boon]

Dear Steve,

I used to think post thyroidectomy scan is easy when there is no thyroid gland, until recently i scanned few follow ups when i am ascertain as they are just post surgical changes or regrow of the thyroid tissue ( or nodule) .

Any input as how you normally scan?

Thank you.

Boon

[Stephen Bird]

Hi Boon,

Great to hear from you,

I agree, they can be difficult.

I just scan the neck as per normal.

If there is any tissue in the thyroid bed, I treat it like thyroid tissue.

So if it has a normal thyroid texture and echogenicity I call it residual thyroid tissue.

If it is hypoechoic, or have punctate echogenic foci or macrocalcification I would call it suspicious, just like if it was a non post op patient.

Then I do a full node assessment of the neck examining the AJCC 6 levels. (please see my webinar about this on the website)

That makes a detailed scan.

You may find some scar tissue that mimics a suspicious thyroid nodule, this is a problem we will all face.

In these cases we can do Nuclear Medicine to ascertain if there is any thyroid tissue present, or a FNA to sample the suspicious area.

Have a great day,

Steve.

[Author]

Posts