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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 54-year-old man with nodal recurrence/persistence of medullary thyroid carcinoma (MTC). Preoperative longitudinal gray-scale sonogram shows an MTC (arrows, 9.3 mm at its largest diameter) in the left thyroid lobe (A) and multiple metastatic lymph nodes (arrows) in the left lateral neck (B). On histopathological examination after total thyroidectomy with lateral neck dissection, there was perithyroidal tumor invasion (T3) and nodal metastasis in the left neck (N1b). The patient showed biochemical remission after thyroid surgery, and the first follow-up ultrasonography (US) at 12 months after thyroid surgery showed normal lymph nodes (arrows) in the left level-III neck (C). On the second follow-up US at 25 months after thyroid surgery, a transverse gray-scale sonogram (D) shows a suspicious LN (arrows, 19.9 mm at its largest diameter) in the left level-III neck. After US-guided fine-needle aspiration for this node, cytology revealed nodal metastasis of MTC, and this lesion was confirmed after the second-look surgery.