Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2023; 11(20): 4883-4889
Published online Jul 16, 2023. doi: 10.12998/wjcc.v11.i20.4883
Microwave ablation of solitary T1N0M0 papillary thyroid carcinoma: A case report
Teresa Dionísio, Leando Lajut, Filipa Sousa, Liliana Violante, Pedro Sousa
Teresa Dionísio, Department of Radiology, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia 4430-000, Portugal
Leando Lajut, Department of Sugery, Centro Hospitalar de Tras-os-Montes e Alto Douro, Vila Real 5000-508, Portugal
Filipa Sousa, Pedro Sousa, Department of Radiology, CHVNGE, Vila Nova de Gaia 4430-000, Portugal
Liliana Violante, Department of Nuclear Medicine, Instituto Português de Oncologia do Porto Francisco Gentil, Porto 4200-072, Portugal
Author contributions: Dionísio T was responsible for the procedure described and had written the manuscript draft; Lajut L performed research and analyzed data.; Sousa F, Violante L and Sousa P reviewed the manuscript and added information and suggestions, according to their area of expertise.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We have no financial relationships to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Teresa Dionísio, MMed, Attending Doctor, Department of Radiology, Centro Hospitalar de Vila Nova de Gaia e Espinho, R. Conceição Fernandes, Vila Nova de Gaia 4430-000, Portugal. tdrdionisio@gmail.com
Received: March 14, 2023
Peer-review started: March 14, 2023
First decision: April 19, 2023
Revised: May 8, 2023
Accepted: June 21, 2023
Article in press: June 21, 2023
Published online: July 16, 2023
Abstract
BACKGROUND

The gold standard treatment for papillary thyroid carcinoma is total thyroidectomy and indications for microwave thermal ablation for primary thyroid cancers have not yet been clearly established However, some patients refuse surgery and others have no indication for it, for example patients under palliative care as in this case, or cannot undergo surgery, based on their comorbidities. These indications are described in the most recent Korean, North American and European guidelines. Laser ablation, radiofrequency ablation, and microwave ablation are similarly safe and effective, so the choice should be based on the specific competences and resources of the pertaining centers. These indications are Percutaneous minimally-invasive techniques; they can be useful to stop disease progression and as an alternative to surgery in patients with contraindication or who refuse surgery. We present a case of a thyroid papillary carcinoma with 17 mm effectively treated with microwave thermal ablation and without recurrence after one year of follow up.

CASE SUMMARY

The authors present a case of a 71-years-old patient with a left lobe papillary thyroid carcinoma with 13 mm × 17 mm × 13 mm, with no indication for thyroid surgery given the context of another cancer in palliative treatment. Microwave thermoablation was performed on December 2021. Four months later he repeated computed tomography (CT) scan, which showed that the tumor had disappeared. Six months after ablation he underwent a positron emission tomography/CT-fluorodeoxyglucose scan, which didn’t show any evidence of hypermetabolic tumor lesions.

CONCLUSION

This case shows microwave thermoablation can be a safe and effective alternative to surgery in patients with no conditions to undergo surgery or when they refuse it. By treating the tumor, with this minimally invasive technique, we are stopping its growth and avoiding disease progression.

Keywords: Thyroid carcinoma, Microwave ablation, Thyroid nodules, Papillary thyroid cancer, Thyroid

Core Tip: The authors present a case of a well succeeded treatment with microwave thermoablation of a papillary thyroid carcinoma, in a patient with no indication for thyroid surgery given the context of another neoplastic disease in palliative treatment.