Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2021; 9(4): 864-870
Published online Feb 6, 2021. doi: 10.12998/wjcc.v9.i4.864
Recurrent medullary thyroid carcinoma treated with percutaneous ultrasound-guided radiofrequency ablation: A case report
Meng-Ying Tong, Hu-Sha Li, Ying Che
Meng-Ying Tong, Hu-Sha Li, Ying Che, Department of Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
Author contributions: Tong MY, Li HS and Che Y contributed to the manuscript writing.
Informed consent statement: Informed consent was obtained from the participant included in the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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: Ying Che, MD, PhD, Professor, Department of Ultrasound, First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, Liaoning Province, China. cheying@dmu.edu.cn
Received: August 14, 2020
Peer-review started: August 14, 2020
First decision: November 26, 2020
Revised: November 29, 2020
Accepted: December 10, 2020
Article in press: December 10, 2020
Published online: February 6, 2021
Processing time: 160 Days and 20.1 Hours
Abstract
BACKGROUND

Treatment for neck lymph node metastases after adequate initial surgery in medullary thyroid carcinoma (MTC) has been controversial. Ultrasound (US)-guided radiofrequency ablation (RFA) has been widely used in recurrent well-differentiated thyroid carcinoma. Here, we report for the first time the use of RFA in a patient with recurrent MTC.

CASE SUMMARY

We report the case of a 56-year-old woman with cervical lymph node metastases of MTC. Four years previously, she had undergone a total thyroidectomy and neck lymph node dissection. A neck US revealed many enlarged nodes during the follow-up period. Moreover, the serum calcitonin jumped to 198.17 pg/mL, which strongly indicated the recurrence of MTC. Subsequently, two metastatic lymph nodes were confirmed by US-guided fine-needle aspiration-cytology and fine-needle aspiration-calcitonin, and then the patient was treated with RFA. Four months later, the neck US and a contrast-enhanced US showed obvious shrinkage in the ablation zones, and the serum calcitonin dropped to 11.80 pg/mL.

CONCLUSION

This case suggests that RFA may be an effective and safe treatment for local recurrent MTC.

Keywords: Medullary thyroid carcinoma; Radiofrequency ablation; Lymph node metastasis; Calcitonin; Fine-needle aspiration; Case report

Core Tip: Adequate surgery is the mainstay of treatment in medullary thyroid carcinoma. However, neck lymph node metastases after adequate initial treatment are present in a majority of cases. So far, treatment for neck lymph node metastases after adequate initial surgery in medullary thyroid carcinoma has been controversial. Radiofrequency ablation, which is considered a moderate approach between secondary surgery and surveillance, may be attempted for these recurrent patients. This case suggests that radiofrequency ablation may be an effective and safe treatment for local recurrent medullary thyroid carcinoma.