Thyroid No Surgery for Small Papillary Thyroid Cancer: Minimally Invasive Radiofrequency Ablation and Keep Your Thyroid gland.

Thyroid No Surgery for Small Papillary Thyroid Cancer: Minimally Invasive Radiofrequency Ablation and Keep Your Thyroid gland.

Thyroid No Surgery for Small Papillary Thyroid Cancer: Minimally Invasive Radiofrequency Ablation and Keep Your Thyroid gland.

Thyroid No Surgery for Small Papillary Thyroid Cancer: Minimally Invasive Radiofrequency Ablation RFA and Keep Your Thyroid gland.

Case Report:

38 Y/O with incidental finding when an enlarged lymph node was found during a routine examination. The biopsy of the node was inflammatory negative. However,the neck ultrasound found a small nodule in the left lobe. The FNA was positive for PTC. A small firm nodule was felt in the left lobe. TSH, FT4  were normal and non detectable antibodies. The nodule was 3.6 mm x 4.3 mm x 4.4 mm ( 0.036 ml ). He saw surgeons who told him he needed surgery. He refused the surgery recommendations and looked for alternative treatment.

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During the evaluation for RFA I told him about another treatment option. Active surveillance with long term follow up. He did not like the idea of a cancer in his neck for years with the possibility of the need for “rescue ” surgery some day.

He decided on RFA therapy.

After informed consent he was prepared for thyroid RFA. Clotting screen, CBC and a negative co-morbidity report form were done.

The procedure was done in my ultrasound room with my nurse, and sonographer assisting. Vital signs were stable throughout the short procedure. The RF Medical RFA system (Korea) was used with ultrasound guidance. It took only 26 minutes with 5 mm  hot tip 7 cm electrode. The maximum watts used was 20. There were no complications early or late. 3 month follow up examination revealed no firm nodule on examination.US: hyper echoic area were the nodule was. FNA found only acellular material.

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3 month post RFA FNA.

He was asked to return at 6 month intervals for several years to do a neck ultrasounds. He elected to not take thyroid hormone at this time.

What happened to him is a major breakthrough for patient with small <1.5 cm papillary thyroid cancer. Instead of surgery with all the risks of major surgery done in the hospital, probable thyroid hormone for life and a scar he elected to use me to  RFA ablate the cancer and leave his thyroid gland intact. This was done in my medical office ultrasound room. The use of Lidocaine to inject the skin and thyroid capsule only allowed him to be awake to answer questions about the state of his recurrent nerve. No general or conscious sedation was used.

Thyroid RFA is a ground braking new procedure that can save you unnecessary thyroid surgery. It is save and less expensive than surgery. The short procedure is followed by a 30 minute observation period after which you can leave.

To see if thyroid RFA is right for you if you have a benign or cancer thyroid nodule, Autonomous functioning thyroid nodule, parathyroid adenoma, or complex cystic nodule unsuited for ethanol ablation call my office for a consultation and details.

Alicia is waiting for your call at 310-393-8860, or secure email at [email protected]

Dr.G.

 

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