Abstract
HIFU is used in the treatment of cancer (prostate, breast) and uterine fibroma but not yet in TNs. This case report describes the first successful ablation of a toxic TN with HIFU. TSH and radioiodine scan normalization were achieved without complications and maintained for 18 months. HIFU treatment is a minimally invasive technique that may be an effective safe alternative to radioiodine or surgery in patients with toxic TNs.
Highlights
We previously reported our preliminary experience with HIFU in the ewe thyroid[11] and describe in the present case report the first successful ablation of an AFTN by using HIFU
Hot right isthmolobar nodule with near-total suppression of extranodular iodine uptake is shown by the 123I thyroid scan
Definitive treatment is always indicated in AFTNs with overt hyperthyroidism and is often recommended for patients with AFTNs and subclinical hyperthyroidism because of the risk of progression to overt hyperthyroidism.[1,2]
Summary
Standard definitive treatments are surgery or radioiodine.[1,2] Locally ablative methods, such as percutaneous intranodular ethanol injection,[3,4] radio-frequency,[5] or laser ablation,[6,7] have been suggested as treatments. An 123I thyroid scan revealed a hot right isthmolobar nodule with near-total suppression of extranodular iodine uptake and a low overall iodine uptake of 2% (Fig 1).
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