Thyroid No Surgery or Radioiodine 101: RFA for Autonomous Functioning Thyroid Nodule AFTN: A case study
Hot Nodule case: In an 18 month follow up the hot nodule was treated with RFA treatment. Prior to RFA: TSH 0.005 normal T4 and T3. Image single hot nodule in left lobe. Ultrasound complex nodule.
2 months later the function of the nodule was reduced and the iodine scan did not show a single hot nodule. The ultrasound was more hypoechoic but still no change in size. The TSH was still suppressed 0.021 with normal T4 T3.
By 3 months S/P RFA the T4, T3 and TSH 1.25 were all normal.The US still persistent nodule but now smaller and all hypoechoic. Thyroid scan was unchanged.
By 18 months the hot nodule was markedly reduced by ultrasound. TSH was normal 0.9 as was the T4 and T3.
RFA can be an alternative to surgery or RAI/131 in selective cases.
One advantage is the return and preservation of normal function in some cases. RFA is not the answer to all hot nodules but can be used in selected cases that refuse surgery or RAI/131 or too sick to undergo surgery.
RFA is not available in the USA now but will be soon. Until then I am sending my patients after an evaluation to Italy or Korea for RFA treatment if they are willing to Fly.
Call Matt at 1-310-393-8860 for details.
Richard Guttler MD,FACE,ECNU