Two Cases of Charcoal Injection in Recurrent Microcarcinoma of Thyroid Bed after Total Thyroidectomy

Abstract

Ultrasonograms and thyroglobulin measurements have high sensitivity for evaluation of recurrent thyroid cancer and they allow early detection of recurrent or residual thyroid tumors. Patients treated for thyroid cancer can show recurrent or residual tumors in 5-40% of cases. Radioiodine therapy and surgical excision are effective for recurrent or residual thyroid tumors, but up to 30% of tumors will not reveal iodine uptake, and need further observation or surgical excision. Clinically, patients choose surgical excision rather than observation. During reoperation, the risk of surgical complications is increased because of fibrosis, neovascularization, and modified anatomical relationships. In the past, surgeons have occasionally used methylene blue during reoperation but it tends to spread into the surrounding tissues. Recently, charcoal injection has been used for recurrent thyroid microcarcinoma. The authors successfully used charcoal injection for the removal of tumor in two cases of recurrent microcarcinoma of the thyroid bed after total thyroidectomy.