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Histologic Features of Papillary Thyroid Carcinoma Treated With Radiofrequency Ablation Followed by Surgical Intervention

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Radiofrequency ablation (RFA) is progressively expanding its application beyond benign thyroid nodules to include malignant thyroid nodules. However, performing thyroidectomy after RFA in the treatment of malignant thyroid nodules, particularly in the context of histopathological analysis and procedural challenges is not well-documented. Here, we present a case of a 50-year-old female patient who underwent RFA based on ultrasound findings suggesting a benign nature, but subsequent fine needle aspiration results confirmed the presence of papillary thyroid carcinoma (PTC), leading to the decision for surgery. Intraoperative findings demonstrated the presence of inflammation and fibrosis attributable to the previous RFA procedure; however, these sequelae did not engender any technical impediments during the surgical intervention, except for adhesions between the thyroid gland and the strap muscles. This case presents intriguing histologic features from a complete specimen for PTC treated with RFA. While further research is warranted, our findings cautiously suggest that RFA may serve as an alternative therapy for PTC cases requiring surgery, as no significant challenges were observed in subsequent surgical procedures.

Abstract

Radiofrequency ablation (RFA) is progressively expanding its application beyond benign thyroid nodules to include malignant thyroid nodules. However, performing thyroidectomy after RFA in the treatment of malignant thyroid nodules, particularly in the context of histopathological analysis and procedural challenges is not well-documented. Here, we present a case of a 50-year-old female patient who underwent RFA based on ultrasound findings suggesting a benign nature, but subsequent fine needle aspiration results confirmed the presence of papillary thyroid carcinoma (PTC), leading to the decision for surgery. Intraoperative findings demonstrated the presence of inflammation and fibrosis attributable to the previous RFA procedure; however, these sequelae did not engender any technical impediments during the surgical intervention, except for adhesions between the thyroid gland and the strap muscles. This case presents intriguing histologic features from a complete specimen for PTC treated with RFA. While further research is warranted, our findings cautiously suggest that RFA may serve as an alternative therapy for PTC cases requiring surgery, as no significant challenges were observed in subsequent surgical procedures.

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