Successful localisation of recurrent thyroid cancer using preoperative patent blue dye injection

B O Evranos; N Ince; H Ataş; S B Polat; H Ahsen; N N Imga; A Dirikoc; O Topaloglu; T Tutuncu; R Ersoy; B Cakir

doi:10.1007/s40618-024-02301-w

Successful localisation of recurrent thyroid cancer using preoperative patent blue dye injection

J Endocrinol Invest. 2024 Feb 14. doi: 10.1007/s40618-024-02301-w. Online ahead of print.

Authors

B O Evranos¹, N Ince², H Ataş³, S B Polat², H Ahsen⁴, N N Imga⁵, A Dirikoc², O Topaloglu², T Tutuncu³, R Ersoy², B Cakir²

Affiliations

¹ Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Ankara Bilkent City Hospital, Ankara, Turkey. evranosberna@gmail.com.
² Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Ankara Bilkent City Hospital, Ankara, Turkey.
³ Faculty of Medicine, Department of Surgery, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey.
⁴ Department of Pathology, Ankara Bilkent City Hospital, Ankara, Turkey.
⁵ Faculty of Medicine, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey.

PMID: 38353922
DOI: 10.1007/s40618-024-02301-w

Abstract

Purpose: In the follow-up of patients with thyroid cancer, recurrences are often detected, posing challenges in locating and removing these lesions in a reoperative setting. This study aimed to assess the effectiveness of preoperative ultrasound (US)-guided injection of patent blue (PB) dye into the recurrences to aid in their safe and efficient removal.

Methods: In this retrospective analysis, we reviewed the records of the patients in a tertiary care centre between February 2019 and March 2023 who underwent US-guided PB injection in the endocrinology outpatient clinic before reoperative neck surgery. The duration between the injection of PB and the initiation of surgery was recorded. The complications and effectiveness of the procedure were evaluated using ultrasonographic, laboratory, surgical, and pathologic records.

Results: We reached 23 consecutive patients with 28 lesions. The recurrences averaged 8.8 mm (4.1-15.6) in size and were successfully stained in all cases. The median time between the PB injection and the incision was 90 (35-210) min. There were no complications related to the dye injection. The blue recurrences were conveniently identified and removed in all cases.

Conclusions: A preoperative US-guided injection of PB is a safe, readily available and highly effective technique for localising recurrent tumours, even in small lesions within scarred reoperative neck surgeries.

Keywords: Blue dye; Localisation; Patent blue; Reoperative surgery; Thyroid cancer recurrences.