Abstract

Objectives: To emphasize a rare complication of the TransOral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) that warrants attention in clinical practice, with the goal of enhancing therapeutic outcomes and patient care quality, as well as discussing prevention strategies.

Case report: A 32-year-old female presented with a right thyroid lobe mass measuring approximately 3x2 cm, associated with a sensation of dysphagia. No lesions were detected in the left lobe, and there was no cervical lymphadenopathy. Neck ultrasound classified the lesion as TIRADS 3, and fine-needle aspiration cytology (FNA) revealed a colloid thyroid nodule (Bethesda category II). The patient underwent right thyroid lobectomy using the transoral endoscopic thyroidectomy vestibular approach (TOETVA). The postoperative course was uneventful, with no immediate complications. At 20 months postoperatively, the patient presented with two painless subcutaneous nodules in the chin region, measuring approximately 1.5x0.5 cm and 1x0.5 cm, respectively. Both were located along the tract of the previous 10-mm trocar. Histopathological examination confirmed benign lesions consistent with normal thyroid tissue, similar to the original pathology.

Conclusion: Recurrence of benign goiter at the port site is a rare complication of TOETVA that warrants clinical attention. The mechanism of recurrence is likely due to the displacement of thyroid cells into the trocar tract during the surgical procedure. Therefore, routine postoperative surveillance is essential for the early identification of potential complications.