Postoperative pseudothyroid on ultrasound: avoiding misinterpretation of the surgical bed

Luis Canales-Franco, Unidad de Imagenología, Hospital Regional de Ñuble, Chillán; Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción; Chile
David Astudillo-Jara, Unidad de Imagenología, Hospital Regional de Ñuble, Chillán; Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción; Chile
Roberto Rouhana-Monagas, Servicios de Medicina y de Hospitalización Domiciliaria, Chile
David Astudillo-Ortega, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción; Servicio de Otorrinolaringología. Hospital Regional de Ñuble, Chillán. Chile

Postoperative pseudothyroid is a transient ultrasound finding observed in the surgical bed after thyroidectomy. It is characterized by occupation of the operative bed by a variable mixture of hemostatic material, organized hemorrhage, inflammatory reaction, and fibroconnective tissue undergoing maturation. This combination may acquire echogenicity and morphology similar to those of a normal thyroid gland, creating the impression of a “false” gland. Recognition of this finding is particularly relevant for radiologists in training, as it may mimic residual thyroid tissue or tumor recurrence.

Keywords: Pseudothyroid. Thyroidectomy. Postoperative. Neck ultrasound.