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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Case Report

Zenker Diverticulum: A Potential Pitfall in Thyroid Ultrasound Evaluation: A Case Report and Systematic Review of Literature

Author(s): Gaetano Achille, Marco Castellana, Sabino Russo, Massimo Montepara, Vito Angelo Giagulli and Vincenzo Triggiani*

Volume 19, Issue 1, 2019

Page: [95 - 99] Pages: 5

DOI: 10.2174/1871530318666180910122003

Price: $65

Abstract

Background and Objective: Zenker Diverticulum (ZD) can sometimes be misinterpreted as a thyroid nodule both at clinical evaluation and at Ultrasound (US).

Case Presentation: We reported the case of a 46-years-old woman complaining of a lump in the anterior left aspect of the neck. Following clinical examination and US evaluation, a thyroid nodule was initially diagnosed and the patient was referred to our institution to be submitted to a fine-needle aspiration cytology.

Management and Outcome: A ZD was suspected by US and diagnosed by gastrografin esophagram, thus an endoscopic diverticulotomy was requested.

Conclusion: A correct US evaluation can be crucial for the appropriate management of a neck mass.

Keywords: Zenker diverticulum, pharyngoesophageal diverticulum, thyroid nodule, ultrasound, systematic review, case report.

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Graphical Abstract

[1]
Bizzotto, A.; Iacopini, F.; Landi, R.; Costamagna, G. Zenker’s diverticulum: Exploring treatment options. Acta Otorhinolaryngol. Ital., 2013, 33(4), 219-229.
[2]
Law, R.; Katzka, D.A.; Baron, T.H. Zenker’s Diverticulum. Clin. Gastroenterol. Hepatol., 2014, 12(11), 1773-1782.
[3]
Gharib, H.; Papini, E.; Garber, J.R.; Duick, D.S.; Harrell, R.M.; Hegedüs, L.; Paschke, R.; Valcavi, R.; Vitti, P. AACE/ACE/AME task force on thyroid nodules. American association of clinical endocrinologists, american college of endocrinology, and associazione medici endocrinologi. Medical guidelines for clinical practice or the diagnosis and management of thyroid nodules - 2016 update. Endocr. Pract., 2016, 22(5), 622-639.
[4]
Haugen, B.R.; Alexander, E.K.; Bible, K.C.; Doherty, G.M.; Mandel, S.J.; Nikiforov, Y.E.; Pacini, F.; Randolph, G.W.; Sawka, A.M.; Schlumberger, M.; Schuff, K.G.; Sherman, S.I.; Sosa, J.A.; Steward, D.L.; Tuttle, R.M.; Wartofsky, L. 2015 american thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid, 2016, 26(1), 1-133.
[5]
Russ, G.; Bonnema, S.J.; Erdogan, M.F.; Durante, C.; Ngu, R.; Leenhardt, L. European thyroid association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: The eu-tirads. Eur. Thyroid J., 2017, 6(5), 225-237.
[6]
Polyzos, A.; Anastasilakis, A.D. Rare potential complications of thyroid fine needle biopsy. Hippokratia, 2011, 15(2), 116-119.
[7]
Lixin, J.; Bing, H.; Zhigang, W.; Binghui, Z. Sonographic diagnosis features of Zenker’s diverticulum. Eur. J. Radiol., 2011, 80(2), 13-19.
[8]
Biggi, E.; Derchi, L.E.; Cicio, G.R.; Neumaier, C.E. Sonographic findings of Zenker’s diverticulum. J. Clin. Ultrasound, 1982, 10(8), 395-396.
[9]
Kim, J.H.; Choi, Y.S.; Kim, B.K.; Lee, J.S.; Park, Y.; Hur, B. Zenker’s diverticulum suspected to be a thyroid nodule diagnosed on fine needle aspiration: A case report. Med. Cases, 2012, 3(4), 261-263.
[10]
Nahra, R.; Tam Kung, J.; Katz, J.; Weinstein, B.; Javid, G. In: An esophageal diverticulum mimicking a thyroid nodule., The Endocrine Society's 95th Annual Meeting and Expo, San Francisco, 15- 18,. 2013.
[11]
Oertel, Y.C.; Khedmati, F.; Bernanke, A.D. Esophageal diverticulum presenting as a thyroid nodule and diagnosed on fine-needle aspiration. Thyroid, 2009, 19(10), 1121-1123.
[12]
Wu, Y.; Lin, R.; Chen, H. The value of fine needle aspiration cytology in differentiation of zenker’s diverticulum from a thyroid nodule. J. Intern. Med., 2016, 27(6), 338-341.
[13]
Abrams, J. Sonographic differential diagnosis of thyroid nodule. pharyngoesophageal diverticulum. HNO, 2011, 59(12), 1215-1218.
[14]
Alessandrini, S.; Samperi, I.; De Cristofaro, F.; D’Armiento, E.; Diacinti, D.; Pernazza, A.; Bosco, D.; Ascoli, V.; Ulisse, S. Zenker diverticulum in the right side of the neck resembling a thyroid mass at ultrasound. J. Biol. Regul. Homeost. Agents, 2016, 30(4), 1229-1234.
[15]
Cui, X.W.; Ignee, A.; Baum, U.; Dietrich, C.F. Feasibility and usefulness of using swallow contrast-enhanced ultrasound to diagnose Zenker’s diverticulum: Preliminary results. Ultrasound Med. Biol., 2015, 41(4), 975-981.
[16]
DeFriend, D.E.; Dubbins, P.A. Sonographic demonstration of a pharyngoesophageal diverticulum. J. Clin. Ultrasound, 2000, 28(9), 485-487.
[17]
Hayashi, N.; Tamaki, N.; Konishi, J.; Endo, K.; Misaki, T.; Torizuka, K.; Mori, T. Lateral pharyngoesophageal diverticulum simulating thyroid adenoma on sonography. J. Clin. Ultrasound, 1984, 12(9), 592-594.
[18]
Kim, J.; Kim, Y.J.; Kim, E.K.; Park, C.S. Incidentally found pharyngoesophageal diverticulum on ultrasonography. Yonsei Med. J., 2002, 43(2), 271-273.
[19]
Ko, H.M.; Boerner, S.L.; Geddie, W.R. Fine-needle aspiration of a pharyngoesophageal diverticulum mimicking a calcified thyroid nodule on ultrasonography. Diagn. Cytopathol., 2013, 4(8), 752-753.
[20]
Komatsu, M.; Komatsu, T.; Inove, K. Ultrasonography of Zenker’s diverticulum: Special reference to differential diagnosis from thyroid nodules. Eur. J. Ultrasound, 2000, 11(2), 123-125.
[21]
Kumar, A.; Aggarwal, S.; Pham, D.H. Pharyngoesophageal (Zenker’s) diverticulum mimicking thyroid nodule on ultrasonography: Report of two cases. J. Ultrasound Med., 1994, 13(4), 319-322.
[22]
Kwak, J.Y.; Kim, E.K. Sonographic findings of Zenker’s diverticula. J. Ultrasound Med., 2006, 25(5), 639-642.
[23]
Nauschuetz, K.K.; Ogden, L.L.; Starling, C.E.; Saleh, M.J.; Golding, A.C.; Traweek, S.T. Pharyngoesophageal diverticula simulating thyroid nodules: An unusual occurrence with unique features. Diagn. Cytopathol., 2018, 46(2), 193-197.
[24]
Puricelli, M.D.; Zitsch, R.P. Is it really a thyroid nodule? Another cause of a lower midline neck mass. Otolaryngol. Head Neck Surg., 2012, 147(2), 397-398.
[25]
Shanker, B.A.; Davidov, T.; Young, J.; Chang, E.I.; Trooskin, S.Z. Zenker’s diverticulum presenting as a thyroid nodule. Thyroid, 2010, 20(4), 439-440.
[26]
Shao, Y.; Zhou, P.; Zhao, Y. Ultrasonographic findings of pharyngoesophageal diverticulum: Two case reports and review of literature. J. Med. Ultrason., 2015, 42(4), 553-557.
[27]
Singaporewalla, R.M.; Mukherjee, J.J.; Thamboo, T.P.; Cheah, W.K. Pharyngoesophageal diverticulum resembling a thyroid nodule on ultrasound. Head Neck, 2011, 33(12), 1800-1803.
[28]
Walts, A.E.; Braunstein, G. Fine-needle aspiration of a paraesophageal diverticulum masquerading as a thyroid nodule. Diagn. Cytopathol., 2006, 34(12), 843-845.
[29]
Wang, Y.; Song, Y. Sonographic characteristics of pharyngoesophageal diverticula: Report of 14 cases and review of the literature. J. Clin. Ultrasound, 2016, 44(6), 333-338.
[30]
Ye-huan, L.; Shi-xu, L.; Yi-li, Z.; Ou-chen, W.; Xiao-hua, Z. Unexpected esophageal diseases appeared in thyroid resections. World J. Surg. Oncol., 2015, 13, 131.https://wjso.biomedcentral.com/articles/10.1186/s12957-015-0542-5
[31]
Kimmey, M.B.; Martin, R.W.; Haggitt, R.C.; Wang, K.Y.; Franklin, D.W.; Silverstein, F.E. Histologic correlates of gastrointestinal ultrasound images. Gastroenterology, 1989, 96(2 Pt 1), 433-441.
[32]
Triggiani, V.; Guastamacchia, E.; Licchelli, B.; Tafaro, E. Microcalcifications and psammoma bodies in thyroid tumors. Thyroid, 2008, 18(9), 1017-1018.
[33]
Achille, G.; Garrisi, V.M.; Russo, S.; Guastamacchia, E.; Giagulli, V.A.; Schirosi, L.; Daniele, A.; Tufaro, A.; Cafagna, V.; Centrone, M.; Simone, G.; Abbate, I.; Triggiani, V. Thyroglobulin determination in fine needle aspiration biopsy washout of suspicious lymph nodes in thyroid carcinoma follow up. Endocr. Metab. Immune Disord. Drug Targets, 2017, 17(3), 213-218.
[34]
Triggiani, V.; Resta, F.; Giagulli, V.A.; Iovino, M.; Licchelli, B.; De Pergola, G.; Tafaro, A.; Benigno, M.; Sabbà, C.; Guastamacchia, E. Parathyroid hormone determination in ultrasound-guided fine needle aspirates allows the differentiation between thyroid and parathyroid lesions: Our experience and review of the literature. Endocr. Metab. Immune Disord. Drug Targets, 2013, 13(4), 351-358.
[35]
Triggiani, V.; Giagulli, V.A.; Licchelli, B.; Resta, F.; Fiore, G.; De Pergola, G.; Sabbà, C.; Guastamacchia, E. Ectopic thyroid gland: Description of a case and review of the literature. Endocr. Metab. Immune Disord. Drug Targets, 2013, 13(3), 275-281.
[36]
Cignarelli, M.; Triggiani, V.; Ciampolillo, A.; Ambrosi, A.; Giorgino, F.; Liso, V.; Giorgino, R. High frequency of incidental diagnosis of extrathyroidal neoplastic diseases at the fine-needle aspiration biopsy of laterocervical lymph nodes in patients with thyroid nodules. Thyroid, 2001, 11(1), 65-71.
[37]
Triggiani, V.; Giagulli, V.A.; Iovino, M.; De Pergola, G.; Licchelli, B.; Varraso, A.; Dicembrino, F.; Valle, G.; Guastamacchia, E. False positive diagnosis on (131)iodine whole-body scintigraphy of differentiated thyroid cancers. Endocrine, 2016, 53(3), 626-635.
[38]
Gao, S.; Xu, Q.; Han, R.L.; Zhao, R.L. Diagnosis and treatment of pharyngoesophageal diverticulum. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2012, 47(12), 1004-1007.

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