SAT480 Diagnosing Dysphagia Due to Thyroid Nodules by Thyroid Ultrasound and the Effectiveness of Radiofrequency Ablation

Disclosure: Z. Idrees: None. M. Morkos: None. Objective: Thyroid nodules can cause dysphagia by direct esophageal compression. Diagnosis of esophageal compression during thyroid ultrasound has not been described. Radiofrequency ablation of thyroid nodules may be able to treat the compressive symptoms. Methods: We present a case series of four patients who presented with dysphagia due to compressive nodular goiter. Thyroid ultrasound was performed by a certified endocrinologist (Endocrine Certification in Neck Ultrasound) who assessed esophageal compression. Nodules were treated with thyroid radiofrequency ablation (RFA). Symptom score, ranging from zero (no symptoms) to ten (severe symptoms), was used to assess the severity of dysphagia before and one month after the procedure. Results: We report four patients who presented with symptomatic thyroid nodules, complaining of dysphagia at the level of the lower neck. Initial symptom scores were 10, 7, 8, and 2 respectively. Thyroid ultrasound demonstrated esophageal compression in all patients due to the culprit responsible nodules and two thyroid biopsies were done to rule out malignancy. Three patients declined surgery and preferred RFA, while the fourth was a poor surgical candidate. RFA was conducted in each by one endocrinologist. The culprit nodules were targeted for RFA, except in case two which was retrosternal. Therefore, a more superficial same-sided nodule was ablated in case two with the goal of reducing mass effect on that side. All the patients reported improvement in their dysphagia and decline in symptom score a month after the procedure to 0, 4, 2, and 0 respectively. Thyroid US demonstrated improvement of esophageal compression one-month after the procedure. No complications were noted. Conclusion: Thyroid ultrasound is a valuable tool in diagnosing dysphagia due to esophageal compression caused by thyroid nodules and in monitoring the response to therapy. Thyroid RFA is a minimally invasive and effective tool for treating symptomatic thyroid nodules. Presentation Date: Saturday, June 17, 2023