The recurrent goitre unusually located near the hyoid bone

Abstract

Introduction: Recurrent goitre is a significant clinical problem among patients who have been operated due to benign lesions. An atypical localization of recurrent goitre - near the hyoid bone - poses additional difficulties as there are no data available on the clinical significance of such lesions. The aim of this study was to analyze if this unusual localization of recurrence is related to any significant differences in the clinical course, and if it significantly increases the risk of thyroid neoplasm.
Material and methods: The outcomes of ultrasound (US) and cytological examinations of 62 patients presenting with a goitre recurrence localised as a focal lesion near the hyoid bone were analyzed (mean age 59.4 ± 12.4 years). The analysis included the period from the operation to the lesion-revealing US, the lesion’s volume, the presence of ultrasound features of malignancy, the volume of residual thyroid tissue in the thyroid bed, the changes in volumes of examined structures, and the outcomes of cytological examinations.
Results: The mean period from the surgery to the US confirming the lesion presence was 16 years, the mean volume of lesion was 2.17 cm³, and the mean period of observation was 3.2 years (ranging from 1 to 10). Fine needle aspiration biopsy was performed in 47 (76%) focal lesions. The cytological results were never suspicious or malignant. In 38% of patients in whom control US was done within the observation period, the lesions enlarged by 20% or more, in 21% of them - by 50%, and in 15% - by over 100%. The category of cytological result did not imply any significant change, even in the case of significant isolated increase in volume of the lesion near the hyoid bone.
Conclusions: Focal lesions near the hyoid bone, revealed in patients operated previously for benign goitre, are not related to increased risk of thyroid neoplasm, and their enlargement does not imply their malignancy.
(Pol J Endocrinol 2010; 61 (5): 448-453)