Endocrine Abstracts

Radiofrequency ablation (RFA) is a minimally invasive technique using thermogenesis to induce tissue necrosis. Initially used to treat hepatocellular carcinoma, RFA is now used to treat numerous conditions including thyroid nodules. We present the use of RFA in 3 individuals with thyroid disease attending our centre. A 31-year-old female presented with symptoms of hyperthyroidism. Her TSH <0.02mIU/l (0.27-4.2), Free T4 (FT4) 20.2 pmol/l (11.9-21.6) and Free T3 (FT3) 8.5 pmol/l (3.1-6.8). Ultrasound demonstrated 1.5 cm cystic nodule in the left lobe of thyroid (TIRADS 1). Pertechnetate scan confirmed increased uptake in the nodule. Fine needle aspiration (FNA) was Thy 1. She was contemplating pregnancy and following discussion underwent RFA of the toxic nodule. Restoration of her thyroid function occurred post RFA; TSH 1.18mIU/l (0.4-4.2), FT4 14.8 pmol/l (9-22) and FT3 5.0 pmol/l (3.1-6.8). A 40-year-old female presented with a large nodule in the right lobe of thyroid. She was clinically and biochemically euthyroid; TSH 0.82mIU/l (0.4-4.2), FT4 12.8 pmol/l (9-22). Ultrasound demonstrated enlarged right lobe of thyroid. A solid cystic nodule replaced much of the lobe measuring 6.7x5.4x3.8cm (TIRADS 2). FNA was benign (Thy 2). RFA of the nodule resulted in reduction in the cystic component of the nodule. A 75-year-old gentleman presented with subclinical thyrotoxicosis; TSH <0.05mIU/l (0.4-4.2), FT4 15.6 pmol/l (9-22) in the setting of a large multinodular goitre extending to sternal notch. Pertechnetate scan confirmed increased uptake throughout the gland, more marked on the right side corresponding to a right sided nodule on ultrasound measuring 3.8cm. FNA was benign (Thy 2). RFA resulted in reduction in size of nodule to 1.9cm. These 3 cases show that RFA is a safe and effective way to manage both toxic and symptomatic thyroid nodules. It is an excellent alternative to surgery. To our knowledge, these are the first cases using RFA in thyroid disease in Ireland.