Sonographic features of traumatic neuromas after neck dissection

J Clin Ultrasound. 2009 May;37(4):189-93. doi: 10.1002/jcu.20566.

Abstract

Purpose: To evaluate the sonographic features of traumatic neuromas after neck dissection.

Methods: This study included 8 patients whose ages ranged from 36-69 years (mean, 49 years). In all cases, traumatic neuromas were incidentally detected at neck sonography for evaluation of suspected recurrence of well-differentiated papillary carcinoma of the thyroid. All sonograms and medical records were retrospectively reviewed.

Results: This study covered 8 cases in which traumatic neuromas were diagnosed by clinical, laboratory, fine-needle aspiration biopsy (FNAB), and other imaging modalities. None of the patients had clinical signs of neuromas, which were, incidentally, discovered by neck sonography. A noticeable sonographic feature in all cases was an isoechoic mass with internal parallel heterogeneous hyperechogenicity. All patients complained of severe pain during FNAB. The cytological results of 2 patients showed fragments of nerve tissue. The remaining 6 FNABs were nondiagnostic. Thyroglobulin (Tg) levels in washout fluids from FNAB of all patients were <0.2 ng/mL, indicating nonthyroidal origin.

Conclusion: Distinctive sonographic features, sharp pain during FNAB, and low Tg levels in FNAB washout fluid can help to diagnose traumatic neuromas without surgery.

MeSH terms

  • Adult
  • Aged
  • Biopsy, Fine-Needle
  • Carcinoma, Papillary / diagnostic imaging
  • Carcinoma, Papillary / pathology
  • Carcinoma, Papillary / surgery
  • Diagnostic Imaging / methods
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / diagnostic imaging*
  • Head and Neck Neoplasms / pathology
  • Humans
  • Immunohistochemistry
  • Incidental Findings
  • Male
  • Middle Aged
  • Neck Dissection / adverse effects*
  • Neck Dissection / methods
  • Neuroma / diagnostic imaging*
  • Neuroma / etiology*
  • Neuroma / pathology
  • Positron-Emission Tomography
  • Sampling Studies
  • Sensitivity and Specificity
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery
  • Tomography, X-Ray Computed
  • Ultrasonography, Doppler*