Endocrine Abstracts

Recently ultrasound-guide radiofrequency thermal ablation has been proposed as an effective and safe procedure for treating patients who have low risk papillary thyroid microcarcinomas or are unfit for surgery. We present the case of a 56 years old patient with a small (10 mm) thyroid nodule diagnosed as TIR 4, suspect citology for papillary carcinoma after fine needle aspiration. The nodule was also studied with CEUS (Sonovue US contrast medium) which showed increased vascularization in the arterial phase compared to the remaining parenchymna and late wash out. We proposed the possibility of radiofrequency thermal ablation to our patient. We used 1 cm active tip electrode needle (HS Amica Gen) with moving shot technique: 3 shots at 30W power for 5 minutes and 15 seconds. The Procedure was safely and effectively carried out. Follow examinations with ultrasonography and CEUS conduced after 1,3,6 months demostrated a complete necrosis with avascular area and progressive reduction of size in the treated site. Anyway we repeated the fine needle aspiration 6 month later and the sample detected only very poor cellularity inflammatory cells, amorphous material and no neoplastic cells. Our experience confirmed that the radiofrequency ablation can effectively eliminated small papillary carcinomas with a very low complication rate. We have to consider this alternative strategy for treatment of small indolent papillary thyroid carcinomas alternatively of traditional patients even without surgical contraindication.