Radiofrequency ablation of low-risk small papillary thyroidcarcinoma: preliminary results for patients ineligible for surgery

Figures & data

Table 1. The clinical characteristics and outcomes of RFA in the 6 patients with low risk small papillary thyroid carcinoma.

						Largest diameter (mm)/volume (mm^3)
Patientnumber	Sex/age	Reason of surgical ineligibility	Underlying disease	Number ofRFA session	Location^a ofpapillary thyroid carcinoma	Before RFA	After RFA	Volumereduction(%)	Symptomsduring RFA	Follow-up periodsat last visit/completedisappearance (months)
1	F/78	Refusal	Bronchial asthma, osteoporosis, cervical spinal stenosis	1	Right isthmus, middle, central, 0 mm	6/47.1	0/0	100	Headache,Hypertension	45/45
2	F/64	Refusal	Radical hysterectomy and bilateral salpingo-oophorectomy due to endometrial carcinoma, bronchial asthma, cervicalspinal stenosis, osteoporosis	1	Right, middle, central, 2 mm	10/219.8	0/0	100	Neck pain	61/24
3	F/76	Refusal	Osteoporosis, lumbar compression fracture, hypertension	1	Left, middle, anterior, 1.5 mm	6/94.2	0/0	100	None	65/48
4	M/79	Refusal	Fatty liver with hyperlipidaemia	1	Right, middle, central, 0.5 mm	11/518.1	3/3.14	99.4	None	48
5	F/65	Risk for general anaesthesia dueto poor PFT	Bronchial asthma, osteoporosis	2	Right, upper, anterior, 0 mm	9/301.4	0/0	100	None	36/12
6	M/70	Refusal	Brain surgery due to acutesubdural haemorrhage	1	Right, lower, central, 2 mm	13/381.0	5/31.4	91.8	None	36

^a Left and right location, cephalocaudal location, anteroposterior location, shortest distance between papillary thyroid carcinoma and thyroid capsule.

RFA: radiofrequency ablation; PFT: pulmonary function test.

Figure 1. Volume changes of ablation zones after radiofrequency ablation of papillary thyroid carcinomas.

Figure 2. (A, B and C) Complete disappearance of papillary thyroid carcinoma after radiofrequency ablation. (A) Ultrasonography of a 64-year-old woman revealed a 10 mm mass proven as a papillary thyroid carcinoma on both fine-needle aspiration and core-needle biopsy in the right thyroid gland. (B) At 1-month follow-up after radiofrequency ablation, ultrasonography revealed a 12 mm ablation zone. (C) At 2-year follow-up, the ablation zone completely disappeared on ultrasonography.

Figure 3. (A–E) Gradual reduction and complete disappearance of papillary thyroid carcinoma after radiofrequency ablation. (A) Ultrasonography of a 76-year-old woman revealed a 6-mm mass in the left thyroid gland. (B) FNA cytology of the mass revealed papillary thyroid carcinoma cells with nuclear atypia, including nuclear grooves, high N/C ratio and nuclear pseudoinclusion (Papanicolaou stain, original magnification ×400). (C) At 2-year follow-up after radiofrequency ablation, US revealed a smaller but persistent, 4-mm ill-defined ablation zone in the left thyroid gland. (D) FNA cytology of the ablation zone demonstrated benign follicular epithelial cells with hemosiderin pigment-laden macrophages (× 100). (E) At 4-year follow-up, US revealed complete disappearance of the ablation zone.

Figure 4. (A–D) Gradual reduction and resultant calcified residues of papillary thyroid carcinoma after radiofrequency ablation. (A and B) Transverse and longitudinal ultrasonography of a 79-year-old man revealed an 11-mm mass proven as a papillary thyroid carcinoma on-fine needle aspiration in the right thyroid gland. (C and D) At 4-year follow-up after radiofrequency ablation, transverse and longitudinal ultrasonography revealed a 3-mm calcified residue in the ablation zone. At 3 year, fine-needle aspiration and core-needle biopsy of the ablation zone revealed no tumour cells (results not shown).