Endocrine Abstracts

Introduction: Radiofrecuency ablation (RFA) represents an alternative to surgery for benign thyroid nodules with pressure symptoms or evident progressive growth.

Objetives: To analyze in our center the efficacy and safety at 6 montns of a single session treatment of RFA performed in predominantly solid thyroid nodules.

Patients and methods: 17 patients with citologically benign thyroid nodules with pressure symptoms (dysphonia, dyspnea, dysphagia, foreign body sensation) or evidence of growth (> 2 mm in two diameters or > 50% of volumen) who refused surgery were treated with RFA using the moving-shot technique. Patients were evaluated at month 1, 3 and 6 of the procedure. Porcentual change form the basal volumen, pressure symptoms,TSH, FT4, Tiroperoxidase antibodies and potential minor complications (hematoma, pain requiring analgesic medication) and major complications voice change, nodule rupture, thyroid disfunction and brachial plexus injury) were recorded.

Results: Mean basal volumen decreased from 26.6±14.8 to 9.9±9.1 ml at month 6 (P<0.05). Percentage of volumen decrease was significant since the first month of RFA (30.3±9.7%) reaching 58.8±21.1% at month 6.Therapeutic success defined as more than 50% in volumen reduction was achieved in 11/17 cases. Presssure symptoms basally recorded in eight patients disappeared in all cases since the first month from RFA and antithyroid drugs could be removed in 2/3 patients with initial subclinical hyperthyroidism. There were no changes in hormonal and antibodies values. Minor complications were reported in ten subjects (five transient paint and five local minor hematomas)and there was only one major complication consistent with a nodule rupture observed at month 1 recovering spontaneously.

Conclusion: One single session treatment of RFA is an effective and safe outpatient procedure in shrinking thyroid benign predominantly solid nodules and in controlling pressure related symptoms. A second session of RFA and a better selection of candidate nodules (obviating those in a confluent nodule background) could improve the percentage of volumen reduction and the prorpotion of patients with successful ablation.