Dr.Guttler’s comments: For carefully selected PTMC, RFA did not have inferior oncologic outcomes after 5 years of follow-up when compared with open surgery THYCA-QoL questionnaire, a specific scale for thyroid cancer patients, to evaluate...More info
Pseudo thyroid nodule: Unknown Long standing Zenker’s Diverticulum with Severe Weight loss sent for Thyroid biopsy.
70 pound F with 10 year history of severe weight loss with symptoms for vomiting undigested food and dysphagia has Hashimoto’s thyroiditis and a “thyroid nodule” on outside Ultrasound. Neck examination was negative for a thyroid...More info
Dr.Guttler’s Comments. Indian Study of 10 patients with the use of RFA for parathyroid adenoma instead of surgery. 9/10 no complications.1/10 had transient hoarseness for 3 weeks. Conclusion was radiofrequency ablation of parathyroid...More info
How A PET/CT Study Saved A Patient From Unnecessary Thyroid Surgery with a Class III atypical cytology and suspicious AFIRMA classifier.
50 Y/O female with a large thyroid nodule who was told to have surgery after the FNA was class III atypical cells, and a AFIRMA GSC classifier suspicious.She was told she had a 50% chance of cancer. She had the nodular goiter for years 2004. She...More info
Why Don’t the Physicians Ever Recommend Thyroid RF to the Patient with Micro-Papillary Thyroid Cancer?
This is a letter from a patient told to have surgery asking me about thyroid RFA. The physicians caring for her never mentioned approved alternative therapy. They did not even mention active surveillance. “What is considered a low risk...More info
Dr.Guttler’s comments: Most over the counter supplements are worthless and put billions in the pockets of the companies. Biotin is not only worthless but it causes thyroid blood testing abnormalities. Hair loss is a serious problem but if...More info
Indeterminate thyroid nodules. The role of 18F-FDG PET/CT in the “era” of ultrasonography risk stratification systems and new thyroid cytology classifications Arnoldo Piccardo, et al Endocrine volume 69, pages 553–561 (2020 DR.Guttler’s...More info
Dr.Guttler’s comments: Not much can go wrong but here is a summary. Unlike the hospital, my patients are watched post RFA for 30-45 minutes while they are checked for any symptoms. They can return to work but no heavy lifting or exercise...More info
Alternative to surgery? Xinyang Li, et al Endocrine Practice Article July 23 2021. DR.Guttler’s comments: 25 patients who were treated with RFA for pHPT in this report. 21/25 had normal PTH at 6 months. Minor complications of neck pain and...More info