P-71 Track recurrence of follicular thyroid carcinoma after transoral endoscopic thyroidectomy vestibular approach

Abstract

Abstract Introduction While track recurrence of thyroid cancer following endoscopic and robotic transaxillary surgeries has been reported previously, no such cases have been reported for transoral endoscopic thyroidectomy vestibular approach (TOETVA). Clinical Case This case report describes the first documented case of recurrence of thyroid cancer along the surgical track after TOETVA. The patient underwent TOETVA to perform a right thyroidectomy for a 4 cm follicular thyroid carcinoma that was initially diagnosed as a benign follicular nodule on preoperative gun biopsy. Ultrasonography and computed tomography conducted 27 months after surgery revealed suspected track recurrence. A re-operation was done in two stages to perform a completion thyroidectomy, bilateral central lymph node dissection, and excision of recurrent nodules, which were pathologically confirmed as metastatic follicular thyroid carcinoma. The patient underwent two treatments of radioactive iodine therapy for remnant thyroid tissues, and post-therapeutic whole-body scintigraphy showed no iodine uptake after the second treatment. Follow-up computed tomography conducted one year after re-operation showed no recurrences. Careful monitoring after TOETVA is essential due to the rare but potential risk of track recurrence. Surgeons should be aware of this atypical complication and be prepared to recommend surgical and/or medical strategies to manage any local seeding of thyroid tissue that may occur.Figure 1.Track recurrence after TOETVA