Needle tract seeding of papillary thyroid carcinoma after fine-needle capillary biopsy: A case report

doi:10.12998/wjcc.v9.i15.3662

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. May 26, 2021; 9(15): 3662-3667
Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3662

Needle tract seeding of papillary thyroid carcinoma after fine-needle capillary biopsy: A case report

Lei Xie, Lian Xia, Yin-Jiao Lei, Liang Zhou, Liu-Hong Shi

Liu-Hong Shi, Liang Zhou, Lei Xie, Department of Head and Neck Surgery, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China

Yin-Jiao Lei, Department of Pathology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China

Lian Xia, Department of Nursing, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China

Author contributions: Xie L conceived and designed the study; Shi LH, Zhou L, Xia L and Xie L contributed to the treatment of the case; Lei YJ performed the histological examination and confirmed the diagnosis; Xia L collected and analyzed data; Shi LH and Zhou L wrote the manuscript; Xie L revised the article and supervised the project; all authors read and approved the final manuscript.

Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.

Conflict-of-interest statement: The authors declare that they have no conflicts of interest.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Lei Xie, MD, Attending Doctor, Chief Doctor, Professor, Department of Head and Neck Surgery, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 Qingchun Road East, Hangzhou 310016, Zhejiang Province, China. xielsrrsh@zju.edu.cn

Received: November 11, 2020
Peer-review started: November 11, 2020
First decision: January 24, 2021
Revised: February 6, 2021
Accepted: March 9, 2021
Article in press: March 9, 2021
Published online: May 26, 2021
Processing time: 173 Days and 23.4 Hours

Abstract

BACKGROUND

Fine-needle biopsy is an accurate and cost-efficient tool for the assessment of thyroid nodules. It includes two primary methods: Fine-needle capillary biopsy (FNCB) and fine-needle aspiration biopsy. Needle tract seeding (NTS) is a rare complication of thyroid fine-needle biopsy mainly caused by fine-needle aspiration biopsy rather than FNCB. Here, we present an extremely rare case of a papillary thyroid carcinoma (PTC) patient with FNCB-derived NTS.

CASE SUMMARY

We report a 32-year-old woman with PTC who showed subcutaneous NTS 1 year after FNCB and thyroidectomy. NTS was diagnosed based on clinical manifestations, biochemistry indices, and imaging (computed tomography and ultrasound). Pathological identification of PTC metastases consistent with the puncture path is the gold standard for diagnosis. Surgical resection was the main method used to treat the disease. After surgery, thyroid function tests and ultrasound scans were performed every 3-6 mo. To date, no evidence of tumor recurrence has been observed.

CONCLUSION

FNCB is a safe procedure as NTS is rare, and can be easily removed surgically with no recurrence. Accordingly, NTS should not limit the usefulness of FNCB.

Keywords: Needle tract seeding; Fine-needle capillary biopsy; Papillary thyroid carcinoma; Rearranged during transfection gene fusion; Thyroglobulin antibody; Case report

Core Tip: Needle tract seeding (NTS) of tumor cells is rare. Given that NTS is mainly caused by fine-needle aspiration biopsy rather than fine-needle capillary biopsy (FNCB), the FNCB-derived deposit of tumor cells has never been reported in papillary thyroid carcinoma. Here, we present a case of NTS caused by FNCB in a papillary thyroid carcinoma patient and performed whole-genome sequencing of the NTS-derived lesion. In this case, subtle changes in the patient’s thyroglobulin and thyroglobulin antibodies were observed. Importantly, the information presented here will help improve the understanding of this disease.