Korean J Radiol.  2016 Aug;17(4):558-561. 10.3348/kjr.2016.17.4.558.

Papillary Thyroid Carcinoma Treated with Radiofrequency Ablation in a Patient with Hypertrophic Cardiomyopathy: A Case Report

• Sun J
• Liu X
• Zhang Q
• Hong Y
• Song B
• Teng X
• Yu J

• KMID: 2455427
• DOI: http://doi.org/10.3348/kjr.2016.17.4.558

Abstract

Standard therapy has not been established for thyroid cancer when a thyroidectomy is contraindicated due to systemic disease. Herein, we reported a patient who had hypertrophic cardiomyopathy and papillary thyroid carcinoma treated by radiofrequency ablation because of inability to tolerate a thyroidectomy. Radiofrequency ablation can be used to treat thyroid cancer when surgery is not feasible, although the long-term outcome needs further observation.

Keyword

Papillary thyroid carcinoma; Hypertrophic cardiomyopathy; Radiofrequency catheter ablation

MeSH Terms

Carcinoma/complications/*diagnosis/pathology/surgery
Carcinoma, Papillary
Cardiomyopathy, Hypertrophic/complications/*diagnosis/pathology/therapy
Catheter Ablation
Female
Humans
Middle Aged
Neoplasm Recurrence, Local
Pacemaker, Artificial
Thyroid Neoplasms/complications/*diagnosis/pathology/surgery
Thyroxine/analysis
Tomography, X-Ray Computed
Triiodothyronine/analysis
Ultrasonography
Triiodothyronine
Thyroxine
Thyroxine

Figure

• 

  Fig. 1 Ultrasound image of thyroid before RFA. A. Transverse ultrasound image. B. Longitudinal ultrasound image. Solid nodule (0.9 × 0.7 × 0.5 cm) with marked hypoechogenicty, microcalcification, and spiculated margin in right thyroid gland. No enlarged lymph nodes were detected. C. Pathological images of thyroid nodule acquired through core needle biopsy (18 G needle). Classical papillary growth pattern can be observed in image (hematoxylin and eosin stain, magnification × 20). D. Malignant nodule was ablated by ultrasound-guided RFA. Longitudinal ultrasound image showing placement of electrode at target nodule with 1 cm active tip. RFA-induced transient hyperechoic zone covered entire nodule and needle passage was also ablated when ablation electrode was retracted. RFA = radiofrequency ablation

• 

  Fig. 2 Follow-up image of thyroid. A. Longitudinal ultrasound image at 1 month after RFA revealed 1.1 × 0.8 cm ablated mass with slight hyperechogenicity. No recurrent or metastases sign was detected. B. Longitudinal ultrasound image at 3 months after RFA revealed 0.9 × 0.5 cm ablated mass with mix-echogenicity; and no suspicious malignant feature was detected. C. Longitudinal ultrasound image at 15 months after RFA revealed 0.9 × 0.6 cm ablated mass with mix-echogenicity; and no suspicious malignant feature was detected. D. Contrast-enhanced computed tomography image at 41 months after RFA. Low density lesion without contrast-enhance was detected in right lobe, no nodule or enlarged lymph nodes were detected. RFA = radiofrequency ablation

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