D E Dupuy1, J M Monchik, C Decrea, L Pisharodi. 1. Department of Diagnostic Imaging, Division of Endocrine Surgery and Pathology, Brown Medical School, Rhode Island Hospital, Providence, RI 02903, USA.
Abstract
BACKGROUND: Regional recurrence of well-differentiated thyroid cancer (WTC) is primarily detected with ultrasonography (US), and current treatment is surgical. Radiofrequency ablation (RFA) has been used primarily for liver tumors as an alternative to a surgical procedure. We have applied RFA to a group of patients with locally recurrent WTC. METHODS: Eight patients underwent percutaneous RFA for biopsy-proven recurrent WTC in the neck (mean size, 2.4 cm; range, 0.8-4.0 cm) while under intravenous conscious sedation and with US guidance. The RF electrode was inserted into the site of recurrence and treated with the maximum allowable current for between 2 and 12 minutes. Follow-up consisted of US in 8 patients, thyroglobulin levels in 6 patients, biopsy in 4 patients, and surgical treatment in 2 patients. RESULTS: All 8 patients with no bleeding or infectious complications were treated as outpatients. A minor skin burn and 1 vocal cord paralysis occurred. No recurrent disease at the treatment site was detected, with a mean follow-up of 10.3 months. Histological examination showed no evidence of a tumor in the treated lymph nodes in 6 patients. Follow-up US examinations showed disappearance of previously detected color Doppler flow, as well as mass shrinkage and internal cystic change, or both. CONCLUSIONS: US-guided RFA is an exciting new treatment modality that appears to have a future role in treating locally recurrent WTC.
BACKGROUND: Regional recurrence of well-differentiated thyroid cancer (WTC) is primarily detected with ultrasonography (US), and current treatment is surgical. Radiofrequency ablation (RFA) has been used primarily for liver tumors as an alternative to a surgical procedure. We have applied RFA to a group of patients with locally recurrent WTC. METHODS: Eight patients underwent percutaneous RFA for biopsy-proven recurrent WTC in the neck (mean size, 2.4 cm; range, 0.8-4.0 cm) while under intravenous conscious sedation and with US guidance. The RF electrode was inserted into the site of recurrence and treated with the maximum allowable current for between 2 and 12 minutes. Follow-up consisted of US in 8 patients, thyroglobulin levels in 6 patients, biopsy in 4 patients, and surgical treatment in 2 patients. RESULTS: All 8 patients with no bleeding or infectious complications were treated as outpatients. A minor skin burn and 1 vocal cord paralysis occurred. No recurrent disease at the treatment site was detected, with a mean follow-up of 10.3 months. Histological examination showed no evidence of a tumor in the treated lymph nodes in 6 patients. Follow-up US examinations showed disappearance of previously detected color Doppler flow, as well as mass shrinkage and internal cystic change, or both. CONCLUSIONS: US-guided RFA is an exciting new treatment modality that appears to have a future role in treating locally recurrent WTC.
Authors: Rebecca S Sippel; Dina M Elaraj; Liina Poder; Quan-Yang Duh; Electron Kebebew; Orlo H Clark Journal: World J Surg Date: 2009-03 Impact factor: 3.352
Authors: Antonio Barile; Simone Quarchioni; Federico Bruno; Anna Maria Ierardi; Francesco Arrigoni; Aldo Victor Giordano; Sergio Carducci; Marco Varrassi; Giampaolo Carrafiello; Ferdinando Caranci; Alessandra Splendiani; Ernesto Di Cesare; Carlo Masciocchi Journal: Gland Surg Date: 2018-04