Radiofrequency Ablation for Locally Recurrent Papillary Thyroid Cancer Refractory to Radioiodine Therapy

Wen-Chieh Chen ； Jung-Fu Chen ； Sheng-Dean Luo ； Chen-Kai Chou ； Wei-Che Lin

《Journal of Radiological Science》 46卷 (2021/03) Pp. 61-69

https://doi.org/10.6698/JRS.202103_46.0013

摘要

PURPOSE. Radiofrequency ablation (RFA) is a well-tolerated alternative to surgery for metastatic papillary thyroid carcinoma (PTC). However, its efficacy for lymph node metastasis refractory to radioactive iodine (RAI) and whether it can be guided by imaging modalities other than ultrasonography (US) remain unclear. This study investigated using computed tomography (CT)- and US-guided RFA for recurrent PTC. MATERIALS AND METHODS. Between January 2018 and April 2019, we recruited 4 middle-aged patients with recurrent, inoperable thyroid cancer who were treated with RFA. All patients previously underwent completion thyroidectomy and neck dissection for PTC and initially had a high postoperative American Thyroid Association risk stratification. All patients received thyroid hormone suppression therapy. Cases 1-3 had lesions next to vital organs, with loss of RAI avidity on whole-body scintigraphy. Case 4 had recurrent PTC with mass effect symptoms; the patient refused to undergo a reoperation. CT-guided RFA was used for Case 1 for a recurrent lesion not visible with US guidance. RESULTS. Two patients received RFA for recurrent tumors per current guidelines, and 2 with more complicated conditions underwent RFA after traditional treatment failure. Decreased serum thyroglobulin concentration or structural remission through RFA was noted. CONCLUSION. In patients with recurrent or difficult-to-reach thyroid tumors and those who refuse to undergo surgery, RFA is a safe and effective option, with a low incidence of complications. CT-guided RFA can be useful for lesions that are difficult to visualize under US guidance.

關鍵字

lymph node metastasis ； papillary thyroid carcinoma ； recurrent thyroid cancer ； computed tomography guidance ； radiofrequency ablation