Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2021; 9(1): 252-261
Published online Jan 6, 2021. doi: 10.12998/wjcc.v9.i1.252
Residual tumor and central lymph node metastasis after thermal ablation of papillary thyroid carcinoma: A case report and review of literature
Yu Hua, Jia-Wen Yang, Liu He, Hua Xu, Hai-Zhong Huo, Chen-Fang Zhu
Yu Hua, Jia-Wen Yang, Liu He, Hua Xu, Hai-Zhong Huo, Chen-Fang Zhu, Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Discipline Construction Research Center of China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai 200011, China
Author contributions: All authors conceived the manuscript, supervised the findings of this work, discussed the results, and contributed to the final manuscript; Hua Y processed the data, drafted the manuscript, and designed the figures; Zhu CF was directly responsible for performing the operation, revising the paper, and supervising the work; Yang JW contributed to analysis and manuscript preparation; He L, Xu H, and Huo HZ analyzed data and prepared figures; All authors have read and approved the final manuscript.
Supported by the Shanghai Municipal Administrator of Traditional Chinese Medicine, No. 2018ZY03005.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that there is no conflict of interests regarding this article.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chen-Fang Zhu, MD, PhD, Doctor, Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Discipline Construction Research Center of China Hospital Development Institute, Shanghai Jiao Tong University, No. 639 Zhizaoju Road, Huangpu District, Shanghai 200011, China. sammizz1977@126.com
Received: September 12, 2020
Peer-review started: September 12, 2020
First decision: September 24, 2020
Revised: October 6, 2020
Accepted: October 27, 2020
Article in press: October 27, 2020
Published online: January 6, 2021
Processing time: 111 Days and 2.9 Hours
Abstract
BACKGROUND

Debate exists regarding the use of thermal ablation (TA) to treat papillary thyroid carcinoma (PTC). Some studies have recommended TA as a new, efficient and safe technology for PTC. In this article, we report one case of a residual tumor and central lymph node metastasis (CLNM) after TA for PTC.

CASE SUMMARY

A 63-year-old female underwent bilateral ultrasound (US)-guided radiofrequency ablation for PTC. Three months later, she was diagnosed as thyroid cancer with suspected CLNM by US and contrast-enhanced computed tomography. The subsequent fine-needle aspiration (FNA) biopsies were negative. Due to her strong personal preference, she underwent total thyroidectomy and central lymph node dissection. Local tissue adhesion and a difficult dissection were noted during the operation. The pathology of the frozen sections during the operation was still negative. The final pathology results of paraffin-embedded sections revealed residual tumor cells at the edge of the PTC and CLNM.

CONCLUSION

TA may lead to a residual tumor in patients with PTC. Follow-up using US and FNA biopsy may not be adequate to evaluate the residual tumor. TA should be carefully considered in PTC treatment.

Keywords: Papillary thyroid carcinoma; Thermal ablation; Residual tumor; Central lymph node metastasis; Follow-up; Case report

Core Tip: Thermal ablation may lead to a residual tumor in patients with papillary thyroid carcinoma. Follow-up using ultrasound and fine-needle-aspiration biopsy may not be adequate to evaluate the residual tumor. Therefore, thermal ablation of papillary thyroid carcinoma should be carefully considered.