Endocrine Abstracts

Aim: Image-guided thermal ablation methods are gaining popularity in recent years for the treatment of benign and malignant thyroid nodules. It has also started to be performed more frequently in our country in the last few years, but few centers have published data on this subject. We aimed to assess the effectiveness and safeness of microwave ablation (MWA) technique in patients with benign thyroid nodules (TNs).

Materials and Methods: This retrospective and single-center study was included 72 patients with 84 benign TNs. Patients aged over 18 years old, diagnosed with USG guided fine-needle aspiration biopsy as benign by the trained pathologists about this subject, who had compression symptoms or cosmetic problems, and patients refusing surgery or at high risk for surgery were included. MWA was performed under local anesthesia. The trans-isthmic approach and moving-shot technique were used during the procedure. The pre-treatment thyroid function tests, nodule volume, cosmetic and symptom scores were compared to the 1 month follow-up. The complications were also noted.

Results: Out of 72 patients, fifty seven (79.1%) were female, and the median age was 50.31±14.26 years. The initial thyroid-stimulating hormone (TSH) and free thyroxine (T4) levels detected in the normal range before and no significant difference were found during follow-up after the ablation technique. The baseline nodule volume was 16.25 mL, and significantly decreased to 7.40 mL one month after treatment (P<0.001). The volume reduction rate (VRR) was 53±20% in female and 58±11% in male patients at the end of the 1st month. There was no significant difference with respect to the gender. The pretreatment mean symptom score was 7.09±1.68, and observed significant improvement after 1 month. The median cosmetic score was 3 (ranged from 1 to 4) before the procedure, and this score reduced significantly to a median of 1 (ranged from 1 to 2) after MWA (P<0.001). This technique was generally well-tolerated by our patients. No life-threatening major complications were observed.

Conclusions: In the treatment of benign symptomatic thyroid nodules MWA is considerable option in terms of efficacy and safety. We consider that awareness of thermal ablation methods should be increased in selected patients due to the drawbacks, need for hospitalization, risk of anesthesia, life-long L-thyroxine replacement therapy and therefore economic burden of surgery.