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. 2018 Mar 15;9:102. doi: 10.3389/fendo.2018.00102

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Copyright © 2018 Ahn, Kim, Lee, Lee, Kim, Choi, Lee, Ryoo, Huh, Sung, Kwak and Baek.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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A 51-year-old man with non-nodal recurrence/persistence of medullary thyroid carcinoma (MTC). Preoperative longitudinal gray-scale sonograms show a primary MTC (arrows, 25.0 mm at its largest diameter) in the right thyroid lobe (A), and a metastatic lymph node (arrows) in the right lateral neck (B). On histopathological examination after total thyroidectomy with lateral neck dissection, there was perithyroidal tumor invasion (T3) and nodal metastasis in the right neck (N1b). The patient exhibited biochemical remission after thyroid surgery, and there was no focal lesion in the postoperative thyroid beds and necks on 6, 12, 18, or 24-month follow-up ultrasonography (US) after thyroid surgery. In the fifth follow-up US at 30 months after thyroid surgery, transverse (C) and longitudinal (D) gray-scale sonograms showed an oval hypoechoic nodule (arrows, 8.0 mm at its largest diameter) in the right postoperative thyroid bed. After US-guided fine-needle aspiration for this lesion, cytology revealed suspicious MTC, and this lesion was confirmed as non-nodal recurrence/persistence of MTC after the second-look surgery.