Endocrine Abstracts

Introduction: Percutaneous laser thermal ablation is a minimally invasive method of shrinking benign thyroid tumors (also used in selected cases of papillary thyroid cancer or primary hyperparathyroidism). Pressure symptoms and a cosmetic defect are main indications for this procedure.

Aim: The aim of the study was to present the results of percutaneous laser thermal ablation for benign thyroid nodules performed in a single Polish center.

Material and Methods: Between 2022-2024, 175 laser thermal ablation procedures were performed (in 160 patients) using the Elesta EchoLaser X4® and the ModiLite® application at the tertiary referral center. From this group, 65 patients with at least one year follow-up were included in the analysis. Thyroid ultrasound was performed immediately before and 12 months after the procedure with the Esaote MyLab Omega ® ultrasound device.

Results: The study group comprised 10 males and 55 females (median age 47 years). Indications for the procedure were compression symptoms in 57 patients (87.7%), a cosmetic defect in 13 patients (20%), subclinical hyperthyroidism in 4 patients (6.2%) and a recurrent cyst in one patient (1.5%). 31 (47.7%) of ablated lesions were predominantly solid with < 50% of the fluid component, 24 (36.9%) - solid, 9 (13.8%) - predominantly liquid with >50% of the fluid component, and one (1.5%) was a pure cyst. 56 patients underwent one procedure, 6 patients - two procedures, and 3 patients - three procedures. The median tumor volume before ablation was 10.85 mL (range 2.86-92.67 mL). Median deposited energy was 5004.9 J (range 1203.0-18285.0 J). The median tumor volume after ablation was 4.21 mL (range 0.38-41.8 mL). The median percentage reduction in tumor volume was 59.87% [4.93-93.47]. The most frequent side effects reported within 7 days after procedure were: pain (22 patients – 33.8%), weakness (13 patients - 20%), flu-like symptoms (11 patients – 16.9%), and neck swelling (10 patients – 15.4%). Longer-lasting complications included: hematoma in 4 patients (6.2%), subacute thyroiditis in 1 patient (1.5%), and a transient recurrent laryngeal nerve palsy in 1 patient (1.5%). Subclinical hyperthyroidism was not resolved in any of four patients despite the reduction in tumor size.

Conclusions: Laser ablation is an effective method of reducing the size of benign thyroid nodules. To authors’ knowledge this is one of the first Polish reports on effectiveness and safety of the procedure.