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Radiofrequency ablation for treatment of locally recurrent thyroid cancer presenting as a metastatic lymph node with dense macrocalcification: A case report and literature review
RATIONALE: Long-term recurrence rate of differentiated thyroid carcinoma has been reported to be as high as 30%. Repeat surgery may be challenging due to normal tissue plane distortion secondary to postoperative fibrosis, especially for small-sized recurrences. Recently, radiofrequency ablation (RFA...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851762/ https://www.ncbi.nlm.nih.gov/pubmed/29489641 http://dx.doi.org/10.1097/MD.0000000000010003 |
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author | Yoo, Roh-Eul Kim, Ji-hoon Paeng, Jin Chul Park, Young Joo |
author_facet | Yoo, Roh-Eul Kim, Ji-hoon Paeng, Jin Chul Park, Young Joo |
author_sort | Yoo, Roh-Eul |
collection | PubMed |
description | RATIONALE: Long-term recurrence rate of differentiated thyroid carcinoma has been reported to be as high as 30%. Repeat surgery may be challenging due to normal tissue plane distortion secondary to postoperative fibrosis, especially for small-sized recurrences. Recently, radiofrequency ablation (RFA) has been suggested to be a safe and effective alternative for high-risk patients or those who refuse surgery. Nonetheless, the efficacy of RFA remains questionable for densely calcified lymph nodes, which would have an increased likelihood of leaving residues after RFA. PATIENT CONCERNS: We present a case of a successful combined treatment of a metastatic lymph node with dense macrocalcification with the use of a single RFA session and radioactive iodine (RAI) ablation in a patient with a previous history of total thyroidectomy and neck node dissection for papillary thyroid carcinoma. DIAGNOSES: A 71-year-old man with papillary thyroid carcinoma underwent total thyroidectomy and neck node dissection followed by RAI ablation. The stimulated serum thyroglobulin level was 4.74 ng/mL at the time of RAI ablation, and the follow-up ultrasonography 3 months later revealed a 15-mm lymph node with dense macrocalcification at the right cervical level III. INTERVENTIONS: After confirming metastasis on cytology, the lesion was treated with ultrasound-guided RFA. OUTCOMES: The single RFA session combined with RAI ablation led to biochemical remission at 5 months after RFA, and complete resolution of structural recurrence including macrocalcification was observed 7 months after the second RAI (1 year after RFA). The patient remained free of recurrence at the 5-year follow-up. LESSONS: RFA may offer a safe and effective alternative to ‘berry picking’ surgery in cases of surgical ineligibility or patient refusal of surgery even when the target lesions contain dense macrocalcification. |
format | Online Article Text |
id | pubmed-5851762 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-58517622018-03-21 Radiofrequency ablation for treatment of locally recurrent thyroid cancer presenting as a metastatic lymph node with dense macrocalcification: A case report and literature review Yoo, Roh-Eul Kim, Ji-hoon Paeng, Jin Chul Park, Young Joo Medicine (Baltimore) 6800 RATIONALE: Long-term recurrence rate of differentiated thyroid carcinoma has been reported to be as high as 30%. Repeat surgery may be challenging due to normal tissue plane distortion secondary to postoperative fibrosis, especially for small-sized recurrences. Recently, radiofrequency ablation (RFA) has been suggested to be a safe and effective alternative for high-risk patients or those who refuse surgery. Nonetheless, the efficacy of RFA remains questionable for densely calcified lymph nodes, which would have an increased likelihood of leaving residues after RFA. PATIENT CONCERNS: We present a case of a successful combined treatment of a metastatic lymph node with dense macrocalcification with the use of a single RFA session and radioactive iodine (RAI) ablation in a patient with a previous history of total thyroidectomy and neck node dissection for papillary thyroid carcinoma. DIAGNOSES: A 71-year-old man with papillary thyroid carcinoma underwent total thyroidectomy and neck node dissection followed by RAI ablation. The stimulated serum thyroglobulin level was 4.74 ng/mL at the time of RAI ablation, and the follow-up ultrasonography 3 months later revealed a 15-mm lymph node with dense macrocalcification at the right cervical level III. INTERVENTIONS: After confirming metastasis on cytology, the lesion was treated with ultrasound-guided RFA. OUTCOMES: The single RFA session combined with RAI ablation led to biochemical remission at 5 months after RFA, and complete resolution of structural recurrence including macrocalcification was observed 7 months after the second RAI (1 year after RFA). The patient remained free of recurrence at the 5-year follow-up. LESSONS: RFA may offer a safe and effective alternative to ‘berry picking’ surgery in cases of surgical ineligibility or patient refusal of surgery even when the target lesions contain dense macrocalcification. Wolters Kluwer Health 2018-03-02 /pmc/articles/PMC5851762/ /pubmed/29489641 http://dx.doi.org/10.1097/MD.0000000000010003 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-sa/4.0 This is an open access article distributed under the Creative Commons Attribution-ShareAlike License 4.0, which allows others to remix, tweak, and build upon the work, even for commercial purposes, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-sa/4.0 |
spellingShingle | 6800 Yoo, Roh-Eul Kim, Ji-hoon Paeng, Jin Chul Park, Young Joo Radiofrequency ablation for treatment of locally recurrent thyroid cancer presenting as a metastatic lymph node with dense macrocalcification: A case report and literature review |
title | Radiofrequency ablation for treatment of locally recurrent thyroid cancer presenting as a metastatic lymph node with dense macrocalcification: A case report and literature review |
title_full | Radiofrequency ablation for treatment of locally recurrent thyroid cancer presenting as a metastatic lymph node with dense macrocalcification: A case report and literature review |
title_fullStr | Radiofrequency ablation for treatment of locally recurrent thyroid cancer presenting as a metastatic lymph node with dense macrocalcification: A case report and literature review |
title_full_unstemmed | Radiofrequency ablation for treatment of locally recurrent thyroid cancer presenting as a metastatic lymph node with dense macrocalcification: A case report and literature review |
title_short | Radiofrequency ablation for treatment of locally recurrent thyroid cancer presenting as a metastatic lymph node with dense macrocalcification: A case report and literature review |
title_sort | radiofrequency ablation for treatment of locally recurrent thyroid cancer presenting as a metastatic lymph node with dense macrocalcification: a case report and literature review |
topic | 6800 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851762/ https://www.ncbi.nlm.nih.gov/pubmed/29489641 http://dx.doi.org/10.1097/MD.0000000000010003 |
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