Radiofrequency ablation for management of thyroid nodules: a case report

Kristanto Yuli Yarsa; Monica Bellynda

doi:10.15562/bmj.v10i1.2150

Radiofrequency ablation for management of thyroid nodules: a case report

Kristanto Yuli Yarsa ,

Monica Bellynda ,

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DOI: https://doi.org/10.15562/bmj.v10i1.2150 |
Published: 2021-04-01

Abstract

Background: Thyroid nodules constitute a frequently seen clinical problem and the incidence of thyroid nodules has increased with the recently increased use of thyroid ultrasonography. Radiofrequency ablation (RFA) is an effective and safe method for treating benign thyroid nodules and recurrent thyroid cancers.

Case Presentation: A 48 years old woman came to the surgical oncology clinic with the presence of a getting bigger, moves when the patient swallows, and painless mass on her neck since 20 years ago. The physical examination measured 5x5 cm mass, mobile on swallowing, no pain on palpation, and the laboratory examination shows a euthyroid state. Â The ultrasound result has revealed an enlargement of the right and left thyroid with increased echo intensity of parenchyma and increased vascularisation. This mass was concluded as struma nodus bilateral. The FNAB was follicular neoplasm, Bethesda system class 4. The patient underwent a single session RFA. RFA was performed employing transisthmic access using a 7 cm 18 gauge electrode-needle with a 1 cm active needle tip. The patient well tolerated the procedure and no adverse events were noted.

Conclusion: Radiofrequency ablation for thyroid lesions is a safe and effective method for treating benign thyroid nodules and even recurrent thyroid cancers. Therefore, various factors, including serum TSH, clinical risk factor assessment, size of the nodule, ultrasound characteristics, patient preferences, and results of the FNA biopsy, should be considered to manage thyroid nodule.

References

Moon WJ, Baek JH, Jung SL, Kim DW, Kim EK, Kim JY, et al. Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J Radiol. 2011;12(1):1-14.
Baek JH, Lee JH, Valcavi R, Pacella CM, Rhim H, Na DG. Thermal ablation for benign thyroid nodules: radiofrequency and laser. Korean J Radiol. 2011;12(5):525-540.
Ha EJ, Baek JH, Lee JH. The efficacy and complications of radiofrequency ablation of thyroid nodules. Curr Opin Endocrinol Diabetes Obes. 2011;18(5):310-314.
Spiezia S, Garberoglio R, Milone F, Ramundo V, Caiazzo C, Assanti AP, Deandrea M, Limone PP, Macchia PE, Lombardi G, Colao A, Faggiano A. Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid. 2009 Mar;19(3):219-25. doi: 10.1089/thy.2008.0202. PMID: 19265492.
Spiezia S, Garberoglio R, Milone F, Ramundo V, Caiazzo C, Assanti AP, et al. Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid. 2009;19(3):219-25.
Faggiano A, Ramundo V, Assanti AP, Fonderico F, Macchia PE, Misso C, et al. Thyroid nodules treated with percutaneous radiofrequency thermal ablation: a comparative study. J Clin Endocrinol Metab. 2012;97(12):4439-45.
Jeong WK, Baek JH, Rhim H, Kim YS, Kwak MS, Jeong HJ, et al. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol. 2008;18(6):1244-50.
Ugurlu MU, Uprak K, Akpinar IN, Attaallah W, Yegen C, Gulluoglu BM. Radiofrequency ablation of benign symptomatic thyroid nodules: prospective safety and efficacy study. World J Surg. 2015;39(4):961-968.
Long B, Li L, Yao L, Chen S, Yi H, Ye X, et al. Combined use of radioiodine therapy and radiofrequency ablation in treating postsurgical thyroid remnant of differentiated thyroid carcinoma. J Cancer Res Ther. 2015;11 Suppl:C244-7.
Dupuy DE, Monchik JM, Decrea C, Pisharodi L. Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy. Surgery. 2001;130(6):971-977.
Kim JH, Yoo WS, Park YJ, Park DJ, Yun TJ, Choi SH, et al. Efficacy and Safety of Radiofrequency Ablation for Treatment of Locally Recurrent Thyroid Cancers Smaller than 2 cm. Radiology. 2015;276(3):909-18.
Park HS, Baek JH, Park AW, Chung SR, Choi YJ, Lee JH. Thyroid Radiofrequency Ablation: Updates on Innovative Devices and Techniques. Korean J Radiol. 2017;18(4):615-623.
Shin JH, Baek JH, Ha EJ, Lee JH. Radiofrequency ablation of thyroid nodules: basic principles and clinical application. Int J Endocrinol. 2012;2012:919650.
Na DG, Lee JH, Jung SL, Kim JH, Sung JY, Shin JH, et al. Radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: consensus statement and recommendations. Korean J Radiol. 2012;13(2):117-25.

[1] Moon WJ, Baek JH, Jung SL, Kim DW, Kim EK, Kim JY, et al. Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J Radiol. 2011;12(1):1-14.

[2] Baek JH, Lee JH, Valcavi R, Pacella CM, Rhim H, Na DG. Thermal ablation for benign thyroid nodules: radiofrequency and laser. Korean J Radiol. 2011;12(5):525-540.

[3] Ha EJ, Baek JH, Lee JH. The efficacy and complications of radiofrequency ablation of thyroid nodules. Curr Opin Endocrinol Diabetes Obes. 2011;18(5):310-314.

[4] Spiezia S, Garberoglio R, Milone F, Ramundo V, Caiazzo C, Assanti AP, Deandrea M, Limone PP, Macchia PE, Lombardi G, Colao A, Faggiano A. Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid. 2009 Mar;19(3):219-25. doi: 10.1089/thy.2008.0202. PMID: 19265492.

[5] Spiezia S, Garberoglio R, Milone F, Ramundo V, Caiazzo C, Assanti AP, et al. Thyroid nodules and related symptoms are stably controlled two years after radiofrequency thermal ablation. Thyroid. 2009;19(3):219-25.

[6] Faggiano A, Ramundo V, Assanti AP, Fonderico F, Macchia PE, Misso C, et al. Thyroid nodules treated with percutaneous radiofrequency thermal ablation: a comparative study. J Clin Endocrinol Metab. 2012;97(12):4439-45.

[7] Jeong WK, Baek JH, Rhim H, Kim YS, Kwak MS, Jeong HJ, et al. Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients. Eur Radiol. 2008;18(6):1244-50.

[8] Ugurlu MU, Uprak K, Akpinar IN, Attaallah W, Yegen C, Gulluoglu BM. Radiofrequency ablation of benign symptomatic thyroid nodules: prospective safety and efficacy study. World J Surg. 2015;39(4):961-968.

[9] Long B, Li L, Yao L, Chen S, Yi H, Ye X, et al. Combined use of radioiodine therapy and radiofrequency ablation in treating postsurgical thyroid remnant of differentiated thyroid carcinoma. J Cancer Res Ther. 2015;11 Suppl:C244-7.

[10] Dupuy DE, Monchik JM, Decrea C, Pisharodi L. Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy. Surgery. 2001;130(6):971-977.

[11] Kim JH, Yoo WS, Park YJ, Park DJ, Yun TJ, Choi SH, et al. Efficacy and Safety of Radiofrequency Ablation for Treatment of Locally Recurrent Thyroid Cancers Smaller than 2 cm. Radiology. 2015;276(3):909-18.

[12] Park HS, Baek JH, Park AW, Chung SR, Choi YJ, Lee JH. Thyroid Radiofrequency Ablation: Updates on Innovative Devices and Techniques. Korean J Radiol. 2017;18(4):615-623.

[13] Shin JH, Baek JH, Ha EJ, Lee JH. Radiofrequency ablation of thyroid nodules: basic principles and clinical application. Int J Endocrinol. 2012;2012:919650.

[14] Na DG, Lee JH, Jung SL, Kim JH, Sung JY, Shin JH, et al. Radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: consensus statement and recommendations. Korean J Radiol. 2012;13(2):117-25.

Radiofrequency ablation for management of thyroid nodules: a case report

Abstract

References

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