Undiagnosed by ultrasound reports thyroid cancer is followed by 11 years

Abstract

Patient came to us to perform thyroid ultrasound after 11 years of follow-up thyroid nodules in other services. In all tests performed previously the nodules were only described, but were not classified by classical sonographic criteria as benign, malignant or dubious, although the description of the nodule on left upper pole was typical of malignancy by internationally accepted criteria, which serve to select the lesion to be biopsied. The patient underwent three fine needle aspiration biopsies in 2001, 2007 and 2009, but as the nodules had not been pre-selected by ultrasound criteria, the most suspicious lesion was never sampled and the material was collected only from the nodes more likely to be benign, which are greater than those subsequently diagnosed as cancer. The exam conducted in 2011 in our department characterized correctly the nodule in the left upper pole as malignant by ultrasound criteria and the biopsy just after confirm as papillary carcinoma. At surgery the cancer was already invading the trachea, more likely due 11 years delayed diagnose that allowed the cancer to invade locally. The authors conclude that sonologist should classify by classical criteria the nodular lesions of thyroid, particularly before biopsy to be done, to avoid this type of mistake that could have serious consequences to the patient.