A false aneurysm

J Laryngol Otol. 2012 Jul;126 Suppl 2:S14-5. doi: 10.1017/S0022215112000370. Epub 2012 Mar 30.


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.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, False / diagnostic imaging*
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Carotid Artery, Internal / diagnostic imaging
  • Diagnosis, Differential
  • Exudates and Transudates
  • False Positive Reactions
  • Humans
  • Laryngeal Neoplasms / diagnostic imaging
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy*
  • Male
  • Middle Aged
  • Neck / pathology
  • Neck Dissection
  • Neck Pain
  • Neoplasm Recurrence, Local / diagnosis*
  • Postoperative Care
  • Radiography
  • Salvage Therapy
  • Thyroid Gland / diagnostic imaging*
  • Thyroidectomy
  • Ultrasonography