Subendothelial Carotid Hematoma After Fine-Needle Aspiration Biopsy of a Solitary Thyroid Nodule

Fine-needle aspiration biopsy (FNAB) is a common, reliable, and inexpensive diagnostic tool in the management of thyroid nodules. It is considered the most accurate and cost-effective method in the investigation of thyroid nodules. 1 Most palpable thyroid nodules can readily be biopsied without sonographic guidance (palpation-guided FNAB). However, nonpalpable nodules or complex nodules containing large areas of cystic degeneration are preferably biopsied under sonographic guidance to increase diagnostic accuracy. 2 ' 3 Complications during the procedure are rare and almost always minor. The most commonly observed complication is intranodular hemorrhage. Other complications include persistent pain, infections, 4,5 acute thyroid hematomas 6 or swelling 7 causing acute upper airway obstruction, recurrent laryngeal nerve injury, 8 and needle tract implantation of a malignant tumor. 9 Here we report a case of carotid puncture and a subsequent subendothelial hematoma after sonographically guided FNAB of a complex thyroid nodule.