2021 Volume 64 Issue 1 Pages 36-42
Core-needle biopsy (CNB) and fine-needle aspiration biopsy (FNAB) are acceptably safe and reliable diagnostic procedures in the management of thyroid nodules/tumors. Herein, we report the case of a patient who developed a hematoma and pseudoaneurysm after CNB of the thyroid, and another of a patient who developed a transient thyroid swelling after FNAB of the thyroid gland. Case 1: A 56-year-old man with hypertension developed a hematoma immediately after CNB of the thyroid. Ultrasound-guided compression was attempted, and he returned home without exacerbation.
However, five hours after the biopsy, he presented with a steadily enlarging neck swelling. Enhanced CT revealed a hematoma and a pseudoaneurysm arising from the superior thyroid artery. Emergency tracheostomy was carried out. Under antihypertensive therapy, the hematoma became smaller and the pseudoaneurysm was resolved. On day 8 after the procedure, he was transferred to another hospital for the treatment of papillary carcinoma of the thyroid with lymph node metastasis.
Case 2: A 45-year-old man presented with a neck swelling, pain on swallowing, and breathlessness two hours after undergoing FNAB of the thyroid gland. Under the diagnosis transient thyroid swelling, cold packs and steroid drips were applied, and the neck swelling promptly resolved. He was discharged on the third day of hospitalization without recurrence.
Neck swelling developing after needle biopsy should be distinguished between hematoma and transient thyroid swelling, and the risk of airway obstruction should be evaluated. It is important to obtain informed consent from patients and provide an explanation about the management of potential complications before performing any invasive examinations.
