ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P763

Case report: percutaneous laser ablation (PLA) to a functional euthyroid autonomous thyroid nodule, and histopathologic effects of PLA on nodule after thyroidectomy at 2nd year of procedure

Bekir Cakir1, Kamile Gul1, Serdar Nevzat Ugras2, Reyhan Ersoy1, Oya Topaloglu1, Tuba Agac1, Cevdet Aydin1, Ahmet Dirikoc1, Mehmet Gumus3, Birol Korukluoglu4 & Ahmet Kusdemir4

1Department of Endocrinology and Metabolism, Ankara Ataturk Education and Research Hospital, Ankara, Turkey; 2Department of Pathology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey; 3Department of Radiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey; 4Department of General Surgery, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.

Objective: Percutaneous laser ablation (PLA) is a new procedure utilized to decrease nodule volume in symptomatic thyroid nodules, to provide euthyroidism in autonomous hyperfunctioning nodules, and to decrease compressive symptoms palliatively in malignant nodules. Standard treatment in autonomous thyroid nodules is radioiodine and surgery. In this report, we aimed to present this case to demonstrate changes in nodule histopathology, which was undergone thyroidectomy two years after PLA procedure.

Case report: We applied PLA in a 25-year-old woman with euthyroid solitary autonomous thyroid nodule due to compression symptoms. A total of 3000 J of energy was applied in 600 s with a power of 5 W in single session. Initial nodule volume was 13.50 ml, which regressed to 4.20 ml within 6 months. However, nodule size began to grow at 9th month, and became 6.50 ml in 1 year. Nodule volume increased to 10 ml at second year of procedure, and compression symptoms reappeared. Thyroidectomy was performed two years after PLA. Macroscopically, thyroidectomy material revealed a white–gray area at the procedure site. Microscopically, there was minimal fibrosis, scarce amounts of old hemorrhagic findings, and multiple microfollicular structures containing colloid in their lumen. Lymphocyte infiltration was observed in thyroid tissue surrounding the nodule.

Conclusion: We did not observe any histopathologic effect of laser on thyroid tissue except lymphoid infiltration. This is the most important histopathologic finding indicating that PLA procedure was a minimally invasive and reliable technique. These are the first long-term data of histopathologic effects of PLA in a benign thyroid nodule which tended to re-grow after procedure. According to these data, PLA application on thyroid nodules is considered safe in long-term.