Thyroid cells seeding along the transaxillary approach after robot-assisted transaxillary surgery (RATS) for a benign node

Abstract

A 46-year-old female presented with a 4-month history of 5–30 mm subcutaneous nodules in the right supraclavicular, axillary, and pectoral areas (Fig. 1). She had undergone a lobo-isthmectomy for a 20 mm right follicular adenoma performed 8 years earlier by robot-assisted transaxillary surgery (RATS). Benign colloid and thyroid cells were found in two successive fine needle aspirations. The CT scan revealed an ill-defined infiltrative lesion in the right central compartment with muscle and internal jugular vein invasion demonstrating a locally aggressive behavior. We suspected that malignant thyroid cells were seeding the tract of the transaxillary approach.