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A false aneurysm

Published online by Cambridge University Press:  30 March 2012

D Mitchell
Affiliation:
Department of Otolaryngology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
C Repanos*
Affiliation:
Department Head and Neck Surgery, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
W B Coman
Affiliation:
Department of Otolaryngology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
*
Address for correspondence: Mr Costa Repanos, ENT Department, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Ports mouth, UK, P06 3LY E-mail: [email protected]

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.

Type
Clinical Record
Copyright
Copyright © JLO (1984) Limited 2012

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