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J Laryngol Otol. 2012 Jul;126 Suppl 2:S14-5. doi: 10.1017/S0022215112000370. Epub 2012 Mar 30.

A false aneurysm.

Author information

1
Department of Otolaryngology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia.

Abstract

OBJECTIVE:

We report a case of a remaining hemi-thyroid following laryngectomy, which was misinterpreted as a pseudoaneurysm.

METHODS:

Case report and comment on this understandable error which is easily avoidable.

RESULTS:

A 59-year-old man had undergone salvage laryngectomy for recurrent squamous cell carcinoma of the larynx, which had previously been treated with radiotherapy. Three months after his laryngectomy, he presented with a sore neck and subcutaneous collections. Computed tomography revealed a unilateral mass with high signal contrast uptake anterior to the left common carotid artery, which was thought initially to be a carotid pseudoaneurysm. Further investigation, including ultrasonography and a review by the senior head and neck radiologist, demonstrated that this mass was actually the remnant hemi-thyroid preserved at laryngectomy (which is often misshapen compared with a normal hemi-thyroid). The collections were found to be recurrent tumour, and unnecessary further interventions were avoided.

CONCLUSION:

Ultrasonography easily distinguishes between a thyroid remnant and a pseudoaneurysm. Furthermore, the opinion of an experienced head and neck radiologist may be vital when interpreting complex post-surgical head and neck radiology.

PMID:
22459590
DOI:
10.1017/S0022215112000370
[Indexed for MEDLINE]
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