indigo-carmine and Carcinoma--Papillary

Identification and removal of small, non-palpable tumors located within previous surgical scar tissue is challenging and time consuming and may be associated with increased risk in patients with recurrent papillary thyroid carcinoma (PTC). The purpose of the present study was to present our surgeon-performed technique and to evaluate the usefulness of ultrasound-guided intratumoral indigo carmine injection (US-III) for intraoperative tumor localization in patients with recurrent PTC.. Sixteen patients with recurrent PTC in which tumors were <1.5 cm and not palpable were enrolled in this prospective study from January 2012 through March 2013.. The mean size of the target tumors was 0.85 cm (range 0.4-1.3 cm) on preoperative US. The average time required for the US-III procedure was 7.7 min (range 5-11 min). The mean volume of injected indigo carmine was 0.56 mL (range 0.3-1.0 mL); this injection expanded the tumors by a mean of 0.2 cm (23.5% increase compared with the initial tumor size; range 0.0-0.4 cm), increasing the mean size of the target tumors to 1.05 cm (range 0.5-1.5 cm). In 15 (93.8%) of the 16 patients, the recurrent tumors were successfully removed with the aid of US-III. No complications occurred in any of the patients as a result of the US-III or subsequent surgeries.. US-III is a safe and effective technique that can be performed by the surgeon for the intraoperative localization of small non-palpable tumors within previous scar tissue in patients with recurrent PTC.

Topics: Adult; Aged; Carcinoma; Carcinoma, Papillary; Chronic Disease; Coloring Agents; Female; Humans; Indigo Carmine; Injections; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Recurrence, Local; Prospective Studies; Surgery, Computer-Assisted; Thyroid Cancer, Papillary; Thyroid Neoplasms; Ultrasonography; Young Adult