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Cracking Thyroid

Published:September 25, 2022DOI:https://doi.org/10.1016/j.amjms.2022.09.016
      A 53-year-old woman with hypoechoic nodule in the left lobe of the thyroid presented to our outpatient clinic. She had no significant medical history or allergies. Cervical ultrasonography of thyroid gland revealed an isoreflective nodule with cystic degeneration (Fig. 1A). Fine needle aspiration biopsy (FNAB) of the nodule was performed using a 22-gauge needle and a 10 ml disposable syringe with previous local anesthesia. Twenty minutes after the procedure, she experienced neck pain and swelling. Additional Doppler ultrasonography showed an acute 2-fold volume increase and a patchy hypoechoic separation in the entire thyroid gland (Fig. 1B-C, yellow arrowhead). There were no clinical symptoms suggesting bleeding or airway obstruction. Based on the clinical findings, we made a diagnosis of cracking thyroid following FNAB. She was treated with conventional cooling, her neck pain and swelling improved in 2 hours without remission.

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