Ha, Eun Ju; Baek, Jung Hwan; Lee, Jeong Hyun; Sung, Jin Yong; Lee, Ducky; Kim, Jae Kyun; Shong, Young Kee
Thyroid : official journal of the American Thyroid Association
2013Mar ; 23 ( 3 ) :289-93.
PMID : 23013110
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Ha, Eun Ju -
Baek, Jung Hwan -
Lee, Jeong Hyun -
Sung, Jin Yong -
Lee, Ducky -
Kim, Jae Kyun -
Shong, Young Kee -
ABSTRACT
BACKGROUND: Surgical management of symptomatic benign thyroid nodules in patients with previous lobectomy poses a dilemma for physicians. Radiofrequency (RF) ablation may provide a treatment option that avoids surgery and preserves thyroid function. We evaluated whether RF ablation of benign thyroid nodules affects thyroid function in patients with previous lobectomy.
METHODS: A total of 11 patients with 14 thyroid nodules were enrolled using the following criteria: (i) having a predominantly solid nodule; (ii) reporting pressure symptoms or cosmetic problems; (iii) cytological confirmation of benignancy; (iv) no malignant features detected using ultrasound; (v) serum thyroid hormone and thyrotropin (TSH) levels within normal limits; and (vi) refusal of or ineligibility for surgery. Thyroid function, nodule volumes, and clinical concerns were evaluated before RF ablation and during follow-up after RF ablation.
RESULTS: The mean follow-up duration after RF ablation was 43.7±30.7 months (range=7-92 months). The mean nodule volume was 9.7 mL (0.9-57.6 mL) before the procedure, and was significantly decreased at the last follow-up (p<0.001) with a mean volume reduction rate of 87.2%. The mean symptom score (p=0.003) and cosmetic score (p=0.003) were both significantly decreased at the last follow-up. Levels of TSH, free thyroxine, and triiodothyronine were not significantly different prior to treatment and at the last follow-up (p>0.05), and remained normal in all patients.
CONCLUSIONS: In patients with previous lobectomy, RF ablation should be considered as a first-line treatment for symptomatic benign thyroid nodules to preserve thyroid function.
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MESH
Adult, Catheter Ablation/*methods, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Thyroid Gland/physiology/radiation effects/*surgery, Thyroid Hormones/blood, Thyroid Nodule/*radiotherapy/*surgery, Thyroidectomy/methods, Thyrotropin/blood, Treatment Outcome
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