Surgical perspective on radiofrequency ablation of thyroid tumors

Abstract

: Radiofrequency ablation (RFA) is a safe and effective, minimally invasive procedure that has been used for decades to treat various tumors in the body. More recently, RFA has been applied to the head and neck, namely the thyroid. Part of its appeal is the lack of a cervical incision, general anesthetic, or removal of the thyroid gland at all, making it an easy office procedure for ablation of benign or malignant tumors. For enlarged benign tumors causing compressive symptoms, RFA can provide a safe option without enduring potential hypothyroidism, or the downtown associated with surgical recovery. For autonomously functioning thyroid nodules (AFTN), RFA may produce modest results for improving symptoms of hyperthyroidism as well as compression, thus expanding the existing options of radioactive iodine (RAI) and anti-thyroidal medications. For the treatment of primary or recurrent thyroid cancer, surgery is the standard of care. However, not all patients are eligible for surgery and in certain instances, revision thyroid surgery for recurrent cancer can pose significant risk to the patient. Thus, the option of a minimally invasive nonsurgical technique for ablation can improve their quality of life and provide clinicians with an extra tool in their armamentarium. We review the literature of this novel procedure and the role RFA can play in treating benign tumors (nonfunctioning and functioning), primary and recurrent thyroid cancers for patients that do not wish to have surgery or are ineligible.