Ultrasound-Guided Percutaneous Ethanol Ablation for the Management of Recurrent Thyroid Cancer: Evaluation of Efficacy and Impact on Disease Course

ABSTRACT Introduction Ethanol (ETOH) ablation of metastatic neck nodes has been described as a potentially safe and effective alternative to surgical excision. We sought to describe a subset of these patients well suited for ETOH ablation. Materials and methods We report ultrasound-guided ETOH ablation of metastatic papillary thyroid cancer (PTC) at a Tertiary Care Endocrine Surgery Unit over 5 years. A retrospective review of all reoperative lymph node dissections was undertaken. Ethanol injection was used as second-line treatment to operative excision and was standardized with ultrasound guidance and the use of 1 cc/cm3 of 100% ETOH solution. Results Five treatments of ultrasound-guided ETOH ablation were studied. All patients had been previously treated with radioactive iodine (RAI) (mean: 1.25 treatments of 174mCi), however, in three cases with pretreatment I-131 scan, no uptake of radioiodine was seen in the treated disease. In four cases with pretreatment fludeoxyglucose-positron emission tomography (FDG-PET), treated lesions were avid. Median follow-up time for treatment was 28.5 months, with no disease progression in all ablated lesions. Serum thyroglobulin (Tg) values in patients without Tg-antibody were lower after treatment. There were no complications. Conclusion Surgeons seeking a less-invasive approach for nodal metastases in the neck can consider ETOH ablation. Small ultrasound detectable lesions in scarred necks (irradiated and/or reoperative) which are radioiodine non-avid and FDG-PET avid may be best suited for this treatment. As demonstrated by a small set of patients in a Tertiary Care Endocrine Surgery Unit, ETOH ablation is safe and effective at controlling progression of targeted local disease. How to cite this article Pasternak JD, Kluijfhout W, Seiser N, Gosnell JE, Suh I, Duh Q-Y, Shen WT. Ultrasound-guided Ethanol Ablation: Where does It fit in the Treatment of Recurrent Metastatic Papillary Thyroid Cancer? World J Endoc Surg 2016;8(3):199-202.

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Recurrent Thyroid Cancer 25 Years after a First Operation

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.55.276 ◽

2004 ◽

Vol 55 (3) ◽

pp. 276-282

Author(s):

Michiro Kawakami ◽

Kanako Ito ◽

Katsuhiro Yoshimura ◽

Hitoshi Tanaka

Keyword(s):

Thyroid Cancer ◽

Recurrent Thyroid Cancer

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Evaluation of clinical presentation and referral indications for ultrasound-guided fine-needle aspiration biopsy of the thyroid as possible predictors of thyroid cancer

Head & Neck ◽

10.1002/hed.24143 ◽

2015 ◽

Vol 38 (S1) ◽

pp. E991-E995

Author(s):

Sara Abu-Ghanem ◽

Oded Cohen ◽

Anna Lazutkin ◽

Yasmin Abu-Ghanem ◽

Dan M. Fliss ◽

...

Keyword(s):

Thyroid Cancer ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Biopsy ◽

Clinical Presentation ◽

Needle Aspiration ◽

Aspiration Biopsy ◽

Ultrasound Guided ◽

Fine Needle ◽

Needle Aspiration Biopsy

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Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer

World Journal of Endocrine Surgery ◽

10.5005/jp-journals-10002-1125 ◽

2013 ◽

Vol 5 (2) ◽

pp. 45-49

Author(s):

Ian C Bennett ◽

Magdalena Biggar ◽

Clement Wong ◽

Michael Law

Keyword(s):

Thyroid Cancer ◽

Thyroid Carcinoma ◽

Lymph Nodes ◽

Differentiated Thyroid Cancer ◽

Intraoperative Ultrasound ◽

Surgical Excision ◽

Ultrasound Guided ◽

Cervical Lymph Nodes ◽

Intraoperative Localization

ABSTRACT As a result of sensitive thyroglobulin assays and widespread use of cervical ultrasound, endocrine surgeons are encountering patients with impalpable suspicious or frankly metastatic cervical lymph nodes in the follow-up phase after treatment for welldifferentiated thyroid cancer. The surgical excision of impalpable disease of recurrent or persistent thyroid cancer can represent a significant challenge which may require some means of intraoperative localization to ensure that affected nodes are removed. Surgeon-performed intraoperative ultrasound (IOUS) can be used for guiding excision of suspicious but impalpable cervical nodes. The IOUS-guided excision technique is described. The successful application of IOUS to localize and guide resection of impalpable nodal recurrences of papillary thyroid carcinoma in two patients is reported. The utilization of IOUS to guide resection of impalpable pathological nodes in the context of thyroid carcinoma is a safe and practical technique which avoids the need for additional localization procedures and unnecessary potential morbidity for the patient. How to cite this article Biggar M, Wong C, Law M, Bennett IC. Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer. World J Endoc Surg 2013;5(2):45-49.

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