Percutaneous Radiofrequency Thermal Ablation in Compressive Thyroid Nodules

Thyroid nodules (TNs) are very common in the general population, with a prevalence of about 50% in subjects older than 60 years undergoing neck ultrasound examination.

The great majority of TNs are benign, but they can be responsible for pressure symptoms in the neck and result in discomfort and decreased quality of life. Large compressive TNs may result in life-threatening conditions because of the potential acute onset of respiratory crisis. Percutaneous radiofrequency thermal ablation (RTA) is a minimally invasive procedure which has been firstly develop to treat patients with liver cancer and has been then used to treat both malignant and benign tumor nodules in many organs. RTA also represents a promising new approach for the management of TNs.The current prospective comparative study investigated the long-term effectiveness of RTA in patients with both toxic and non-toxic compressive TNs.

Forty consecutive patients with TNs with pressure symptoms were prospectively enrolled in this study. Patients were randomised as follows: 20 patients were treated with a single RTA session (group A) and 20 patients did not receive any treatment and were only followed-up (group B).

Inclusion criteria

• age > 18 years;
• benign thyroid nodules (TYR 2)
• solid or predominantly solid (colloid component < 30%) large (> 4.0 mL) thyroid nodules
• refusal and/or inefficacy of surgery and/or radioiodine therapy.

Exclusion criteria

• pregnancy
• malignant or suspicious thyroid nodules.