Radiology, Vol 207, 405-409, Copyright © 1998 by Radiological Society of North America
Thyroid gland after total laryngectomy: CT appearance
JL Weissman, HD Curtin and JT Johnson
Department of Radiology, University of Pittsburgh Medical Center, PA 15213, USA.
PURPOSE: To determine the computed tomographic (CT) appearance of the
normal thyroid gland after total laryngectomy, because the high attenuation
(or heterogeneous attenuation) of thyroid parenchyma was misinterpreted as
tumor on several CT studies. MATERIALS AND METHODS: A search of
computerized clinical files compiled from January 1996 through August 1997
yielded data on 24 patients who had undergone laryngectomy and subsequent
CT of the neck. From these 24 patients, CT findings were available in 21.
Because one patient had undergone total thyroidectomy and was excluded from
the study, a retrospective review was performed in the remaining 20
patients. RESULTS: In 14 patients, unilateral thyroid tissue was present;
in the other six there was bilateral thyroid tissue not connected by an
isthmus. Thus, there were 26 remaining thyroid lobes, of which six were
round and 20 were oval or lobular. Nineteen lobes showed homogeneously high
attenuation (including one scanned without use of contrast material), six
showed heterogeneous high attenuation or contained areas of hyperlucency,
and one was obscured by streak artifact. CONCLUSION: Thyroid tissue can
appear as unilateral or bilateral asymmetric masses on neck CT scans after
laryngectomy. Gland tissue can show homogeneously or heterogeneously high
attenuation. Familiarity with the varied postoperative appearance of normal
thyroid gland can prevent its misdiagnosis as tumor.
