Large Benign Thyroid Nodules 101: Surgery is Not the First Choice for Treatment Anymore !
Benign Thyroid Cysts and Solid Nodules can be ablated with thyroid ethanol PEI or radiofrequency ablation RFA as an outpatient in a few minutes without a scar or post surgery complications.
In the past very large benign solid nodules were considered too big for Thyroid RFA. Very large thyroid or parathyroid cysts were still treated with ethanol as the first line treatment.
Now even 10 cm solid cystic nodules can be treated but may need several sessions to complete the ablation.
The patient seen here had ethanol ablation of the cystic parts with partial symptom relief but still had a significantly large nodule and a cosmetic issue as well. Enter the master of RFA in Korea Dr.JH Baek. The first session when she arrived in Korea deceased the size by 40%. She will return for the second session in 3 months.Large nodules take longer to ablate and she needed 60 minutes instead of 20 minutes of the average smaller nodules.
She also had blood vessels near the capsule that were taking away the heat.They were ablated before the nodule could be treated.
There are few places in the world at present willing to take on very large nodules.
Professor Baek and his team at Asan Medical Center in Seoul Korea have been doing large nodule since 2002.
Another example of ablation of a large nodule in Seoul.
Call me at 310-393-8860 or email at [email protected]
for details on my evaluation prior to going to Korea. After evaluation and repeat biopsy.
I will send the data to Dr.Baek for his approval.If he agrees to take you on you can fly to Seoul
for a one session treatment for smaller nodules or a return visit for a 2 session ablation of
very large nodules. Compared to surgery, the complications with thyroid RFA in Korea are few and rarely cause significant morbidity while major surgical complications of parathyroid damage and vocal cord paralysis do not occur with RFA.
3.3% total and 1.4% major and only 0.14 % caused sequelae. Temporary Voice change, and hematoma were the cause of 62% of all the short term complications. Next was temporary vomiting at 19% and skin burn in 9%. Rare hypothyroidism was seen in 2% of the complications needing thyroid hormone replacement.
Richard Guttler MD,FACE,ECNU