Thyroid Biology and Disease

SAT-407 - Cervical Esophageal Diverticulum Mimicking Thyroid Nodule Following Total Thyroidectomy for Papillary Thyroid Carcinoma

Saturday, June 13, 2026

9:30 AM - 4:30 PM CT

Location: ENDOExpo; Poster Floor

Abstract Poster Presenter(s)

PP

Prima Poudel, MD

Michigan State University College of Human Medicine
East Lansing, Michigan, United States

Co-Author(s)

SA

Saleh Aldasouqi, MD

Michigan State University College of Human Medicine
East Lansing, Michigan, United States
AA

Ahmad Abu Limon, MD

Michigan State University
East Lansing, Michigan, United States
FA

Folake Akanbi, MD

Michigan State University
East Lansing, Michigan, United States
SK

Shaza Khan, MD

MICHIGAN STATE UNIVERSITY
East Lansing, Michigan, United States
ER

Era Rawal, MD

Michigan State University College of Human Medicine
East Lansing, Michigan, United States
HN

Hana Nadeem, MD

Michigan State University College of Human Medicine
East Lansing, Michigan, United States

Background:
Post‑thyroidectomy surveillance for papillary thyroid carcinoma (PTC) relies on a combination of biochemical thyroid marker measurement and cervical imaging to watch for recurrence. Post surgical imaging surveillance can show abnormalities that can occasionally mimic recurrence, prompting unnecessary interventions.

Case Presentation:
An 82‑year‑old woman with long‑standing hypothyroidism and strong family history of thyroid disease underwent total thyroidectomy in February 2023 for multinodular goiter (FNA Bethesda VI). Pathology confirmed classical PTC, 8 mm in size, low grade, with a close ( < 1 mm) surgical margin. She received 106 mCi of I‑131 ablation postoperatively, and subsequent scans showed only remnant uptake. Serial Tg levels remained < 0.1 ng/mL with progressively declining anti‑Tg antibodies.

During routine surveillance in September 2025, neck ultrasound demonstrated new soft‑tissue development measuring 1.3 cm in the left thyroid bed, suspicious for recurrence. CT neck revealed a partially fluid‑ and gas‑filled paraoesophageal structure adjacent to the left thyroid bed. A barium swallow confirmed a small cervical esophageal diverticulum with localized leak, without abscess or inflammation. The patient was asymptomatic and managed conservatively after multidisciplinary evaluation (Endocrinology, Gastroenterology and Thoracic Surgery).

Discussion:
Cervical esophageal diverticulum or localized esophageal leak is an exceedingly rare postoperative finding that can mimic recurrence, particularly when Tg levels remain undetectable.

Conclusion:
Correlating imaging with biochemical surveillance and using multimodal imaging are essential to prevent unnecessary biopsy or surgical re‑exploration. Recognition of esophageal diverticulum as a benign mimic is critical during long‑term thyroid cancer follow‑up.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*