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      Charcoal-Induced Granuloma That Mimicked a Nodal Metastasis on Ultrasonography and FDG-PET/CT after Neck Dissection

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          Abstract

          Charcoal can be used for preoperative localization of metastatic lymph nodes in the neck. Charcoal remains stable without causing foreign body reactions during as hort period. However, foreign body reactions may develop if charcoal is left in situ for more than 6 months. We reported a case of charcoal granuloma mimicking local recurrence on fluorodeoxyglucose-positron emission tomography/computed tomography and ultrasonography in a 47-year-old woman who had cervical lymph node dissection due to metastatic invasive ductal carcinoma of the breast.

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          Posttreatment CT and MR imaging in head and neck cancer: what the radiologist needs to know.

          Naoko Saito, Rohini N Nadgir, Mitsuhiko Nakahira … (2024)
          In patients with head and neck cancer, posttreatment imaging can be complicated and difficult to interpret because of the complexity of the surgical procedures performed and the postirradiation changes, but such imaging is critical for the evaluation of (a) the response to therapy and (b) tumor control. Posttreatment changes are affected by the type of surgery performed, reconstruction, neck dissection, and radiation therapy. Three types of flaps are used for reconstruction in the head and neck region: (a) the local flap, with geometric repositioning of adjacent tissue; (b) the pedicle flap, with rotation of donor tissue and preservation of the original vascular system; and (c) the free flap, with transfer of tissue that is revascularized by using microvascular surgical techniques. The posttreatment imaging findings in patients with head and neck cancer can be divided into four groups: altered anatomy secondary to surgical reconstruction, tumor recurrence, potential postsurgical complications, and possible postirradiation changes. Potential postsurgical complications are wound infection, abscess, fistula, flap necrosis, hematoma, chylous fistula, and serous retention. Possible postirradiation changes include mucosal necrosis, osteoradionecrosis, radiation-induced vasculopathy, radiation pneumonitis, radiation lung fibrosis, radiation-induced brain necrosis, and radiation-induced secondary malignancies. A familiarity with the imaging characteristics of posttreatment changes and of the potential complications caused by surgery and irradiation and an ability to differentiate these findings from tumor recurrence are essential for posttreatment surveillance and follow-up management of patients with head and neck cancer.
          Article 0 comments Cited 23 times – based on 0 reviews     Review now
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            Preoperative ultrasound-guided tattooing localization of recurrences after thyroidectomy: safety and effectiveness.

            E. Ko, T Kang, Kyu Hahn … (2009)
            The incidence of nonpalpable recurrence detected on follow-up ultrasound (US) after thyroidectomy has increased. However, surgical approach for nonpalpable lesions can be difficult. We assessed the safety and effectiveness of ultrasound-guided tattooing (US-tattoo) with a charcoal suspension for localizing nonpalpable cervical recurrences after thyroidectomy for thyroid cancer. Between March 2004 and February 2008, we retrospectively assessed 55 consecutive patients with 83 lesions who underwent US-tattoo with injection of a charcoal suspension for nonpalpable lesions. All patients underwent the surgical dissection after US-tattoo. The complications and effectiveness of US-tattoo were evaluated using ultrasonographic, surgical, and pathologic records. Among 83 lesions, 72 recurrences and 11 benign lesions were confirmed by final pathology. The average size of the localized lesions was 0.7 cm (range 0.4-1.4 cm). The most common site of tattooing was cervical lymph nodes at level IV. The technical success rate of US-tattoo for suspicious lesions was 96% (80/83). Failure of US-tattoo occurred in lesions located posterior to major vessels. During surgery, all but two successful tattooed lesions were detected by surgeons. No residual lesion was detected at follow-up US. With regard to complications, two patients (4%) had a dot-like marking at the skin puncture site after US-tattoo. Preoperative US-tattoo is a safe and effective method for successful reoperation of nonpalpable recurrences after thyroidectomy.
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              Suture Granuloma Mimicking Recurrent Thyroid Carcinoma on Ultrasonography

              Yong Chung, Eun-Kyung Kim, Min Kim … (2006)
              Although high resolution ultrasonography (US) is helpful in the differentiation of suture granulomas from recurrent thyroid cancer in most cases, a definite diagnosis cannot always be made. We report a case that mimicked recurrent thyroid cancer on US and 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET), but diagnosis of a suture granuloma was confirmed by a US-guided fine needle aspiration biopsy (FNAB). In order to avoid unnecessary operations, the differential diagnosis between postoperative suture granulomas and recurrent cancer is important.
              Article 0 comments Cited 12 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Korean J Radiol
                Journal ID (iso-abbrev): Korean J Radiol
                Journal ID (publisher-id): KJR
                Title: Korean Journal of Radiology
                Publisher: The Korean Society of Radiology
                ISSN (Print): 1229-6929
                ISSN (Electronic): 2005-8330
                Publication date (Print): Jan-Feb 2015
                Publication date (Electronic): 09 January 2015
                Volume: 16
                Issue: 1
                Pages: 196-200
                Affiliations
                [1 ]Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea.
                [2 ]Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea.
                [3 ]Department of Pathology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea.
                [4 ]Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 143-729, Korea.
                Author notes
                Corresponding author: Won-Jin Moon, MD, Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 143-729, Korea. Tel: (822) 2030-5499, Fax: (822) 2030-5549, mdmoonwj@ 123456naver.com
                Article
                DOI: 10.3348/kjr.2015.16.1.196
                PMC ID: 4296270
                SO-VID: 05cfc0a9-df1e-497a-90e0-2c1d8985fae7
                Copyright © Copyright © 2015 The Korean Society of Radiology
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 19 June 2014
                Date accepted : 17 October 2014
                Funding
                Funded by: Ministry of Health and Welfare
                Award ID: HI12C0713
                Categories
                Subject: Nuclear Medicine
                Subject: Case Report

                ScienceOpen disciplines: Radiology & Imaging
                Keywords: charcoal granuloma,fdg-pet/ct,ultrasound, neck
                Data availability:
                ScienceOpen disciplines: Radiology & Imaging
                Keywords: charcoal granuloma, fdg-pet/ct, ultrasound, neck

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