Objective: Ultrasound (US) guided percutaneous laser ablation (PLA) is a new procedure utilized to decrease nodule volume in symptomatic thyroid nodules, to provide euthyroidism in autonomous hyperfunctioning thyroid nodules, and to decrease compressive symptoms palliatively in malignant nodules. Standard treatment protocol in symptomatic benign hypoactive thyroid nodules is surgery, if needed LT4 suppression, and radioiodine treatment in certain applications. We applied PLA to 42-year-old male patient with 16.8 ml volume solid hypofunctioning benign thyroid nodule.
Case report: The procedure was planned to inferior and superior parts of the nodule. First application to inferior part of nodule was performed in single session with 3 W power, and 720 J was applied in 240 s. Control US images after the procedure showed formation of subcapsular hematoma in inferior anterior part of nodule. Although patient had no complaints like dysphagia, dyspnea, or pain, 2nd part of procedure was cancelled. Patient was closely monitored in coordination with surgical team. Hematoma was absorbed largely within 48 h. It disappeared completely at first month.
Conclusion: Various complications have been reported after diagnostic and therapeutic interventions to thyroid nodules. Cervical pain, hoarseness due to laryngeal injury, and hematoma are most frequent of these. PLA is applied as one of non-surgical treatment methods in treatment of solid thyroid nodules in recent years. Pain, hoarseness, fever, and hyperthyroidism have been reported as complications after PLA in several case series, but hematoma has not been, up to now, reported as a complication of PLA. We considered publication of this case report because development of subcapsular hematoma after PLA was not previously reported in literature.
03 - 07 May 2008
European Society of Endocrinology