Sonographic features of traumatic neuromas after neck dissection

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.