Vanishing thyroid gland tumors: Infarction as consequence of FNA?

Abstract

Fine-needle aspiration (FNA)-induced secondary changes were described in various organs. Complete replacement of tumor by necrosis causes diagnostic and management problems. Seven cases of totally or partially vanished thyroid lesions were identified from the archive of Department of Pathology, Fimlab Laboratories within 5year period. Histopathological slides were revised in all cases. Total thyroidectomy or lobectomy samples were from 4 females and 3 males patients aged 37-83 years (mean 67.1 years). Imaging data were available in 6 cases. Cytology slides and data were available only in 3 cases: two revealed follicular neoplasm and one was insufficient according to Bethesda system. In 5 cases, final histopathology revealed total necrosis of the lesion with only one case with available cytological diagnosis of oncocytic follicular neoplasm. In remaining 2 cases, replacement by necrosis was partial. Of note, in three cases, oncocytic metaplasia was present. Total histopathological blocking with thorough check of capsular areas is recommended in necrotic tumors. Vanishing thyroid lesion phenomenon is rare, but in cases of disappearance of tumor, preoperative cytology diagnosis is the only clue for the patient management. Diagn. Cytopathol. 2016;44:568-573. © 2016 Wiley Periodicals, Inc.