LAUSR

Total thyroidectomy is a commonly performed endocrine surgery, recommended both in case of benign and malignant thyroid disease. The procedure is generally safe, although a minority of cases could present complications as postoperative hypoparathyroidism or recurrent laryngeal nerve dysfunction [1]. Suture granulomas could be considered among the complications of the operation and they are benign inflammatory lesions caused by the nonabsorbable suture used for the surgery. Cervical ultrasound (US) of the thyroid bed and central and lateral cervical nodal compartments is an essential component of the monitoring over time of patients diagnosed with differentiated thyroid cancer following surgery and it should be performed periodically, depending on the patient’s risk for recurrent disease [2]. The increased use of US as a first-line exam for evaluating locoregional recurrence after thyroidectomy led to the identification of many other postoperative abnormalities mimicking local tumor recurrence such as benign reactive lymph nodes, residual thyroid tissue, hyperplastic parathyroid glands, and, specifically, suture granulomas [3, 4]. Linear internal echoes have been identified in several previous studies as a characteristic sign of suture granulomas, although not all studies agree that sonographic features alone can effectively distinguish between recurrent thyroid cancer and nonrecurrent benign lesions [5–9]. Here we describe the case of patient with bilateral suture granuloma detected after total thyroidectomy lacking the typical sonographic appearance of stitch granulomas [6–8].