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

Endocrine Abstracts (2019) 63 P405 | DOI: 10.1530/endoabs.63.P405

Radiofrequency ablation in the treatment of benign thyroid nodules: a good alternative to surgery

Cristina Moreno, Miguel Paja, Ana Izuzquiza, Javier Espiga, Cristina Arrizabalaga, Adela Leyre Martínez, Andoni Monzon, Rosa Zabala, Natalia Iglesias & Laura Calles

Basurto Universitary Hospital, Bilbao, Spain.

Introduction: To date, benign thyroid nodules complainig of symptomatic or cosmetic problems and autonomous functioning thyroid nodules (AFTN) have generally been treated with surgery or I131. Radiofrequency ablation (RFA) is a novel technique that has demonstrated safety and efficacy in the treatment of these nodules. We describe the clinical experience at our hospital.

Material and method: We include 33 patients (28 women, 5 men) from January 2013 to September 2018. The mean age was 50.1 years (range 20-83) and TSH 1.17 mUI/L (0.041-4.31). Malignancy was previously ruled out with core needle biopsy (CNB). 55% were located in the left thyroid lobe, 40% in the right and 6% in the isthmus. The content of the nodules was: 51.5% solids with an initial volume of 32.10 ml (±25.23), the 36.5% mixed with a volume of 27.25 ml (±25.16) and 12% cystic with volume of 17.48 ml (±13.06). The patients had a minimum follow-up of 6 months and maximum of 2 years. The indications of the technique were: 12 AFNT, 10 cosmetic problem, 9 pressure clinic and 2 for great size.

Results: 100% of the nodules underwent a decrease in size with an average reduction of 64% at 12 months. The maximum reduction occurred at 12 months in solids (64%), at 18 months in mixed (83.65%) and at 24 months in cystic (79.27%). Of the 12 AFTN, 100% normalized TSH at 3 months. Of the patients with local clinic, 50% underwent partial improvement and the other 50% experienced disappearance of the symptoms. As complications there were 1 local 2-week pain, 1 self-limiting perinodular hemorrhage, 2 temporal recurrence dysphonia and 3 mild and self-limited hyperthyroidism. 2 solid nodules experienced regrowth at 18 months. There was no case of hypothyroidism.

Conclusiones: ARF is an effective technique for the decrease in size of thyroid nodules, especially those of mixed content. It is very useful for AFTN with normalizationof thyroid function in all cases. This technique presents few complications and prevents hypothyroidism so it is a good alternative to I131 or surgery.