Ultrasound-guided needle localization in trans-mammary endoscopic thyroidectomy: a case report

Combining ultrasound-guided localization needles with endoscopic thyroidectomy via the trans-breast approach offers a minimally invasive surgical option that preserves thyroid function and aesthetics while enabling precise resection of thyroid nodules, minimizing damage to normal tissue, and improving patient outcomes. This surgical method holds great potential in the field of thyroid surgery, achieving a balance between radical resection and functional preservation. Highlights 1. Precision-guided minimally invasive surgery: this study introduces an innovative integration of ultrasound-guided needle localization with endoscopic thyroidectomy via the areola approach, achieving highly precise resection of thyroid nodules. The method significantly improves surgical accuracy, especially for small or nonpalpable nodules located deep within the thyroid gland. 2. Function-preserving surgical strategy: by restricting the resection margin to only 0.5 cm beyond the lesion, the technique maximizes preservation of normal thyroid tissue. Consequently, the patient maintained relatively stable postoperative thyroid function, requiring only minimal hormone replacement therapy. 3. Excellent cosmetic and clinical outcomes: the areola-based access route provided a scar-free aesthetic result, while the patient recovered smoothly without complications such as hoarseness or hypocalcemia. The procedure was completed in a reasonable duration with minimal blood loss, underscoring both the safety and efficiency of the approach. 4. Pathological and functional validation: postoperative pathology confirmed complete resection of a papillary thyroid carcinoma in the right lobe and a noninvasive follicular thyroid neoplasm in the left lobe. No residual disease was detected, and subsequent thyroid function tests validated the success of the tissue-preserving strategy. This case highlights a promising advancement in thyroid surgery by merging technological precision with functional and cosmetic priorities. It underscores the potential for broader clinical adoption of approaches that balance oncologic safety with quality-of-life outcomes.