Tong Meng-Ying, Li Hu-Sha, Che Ying
Department of Ultrasound, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China.
World J Clin Cases. 2021 Feb 6;9(4):864-870. doi: 10.12998/wjcc.v9.i4.864.
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.
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.
This case suggests that RFA may be an effective and safe treatment for local recurrent MTC.
甲状腺髓样癌(MTC)初次手术充分后颈部淋巴结转移的治疗一直存在争议。超声(US)引导下的射频消融(RFA)已广泛应用于复发性高分化甲状腺癌。在此,我们首次报告RFA在复发性MTC患者中的应用。
我们报告了一例56岁女性MTC颈部淋巴结转移的病例。四年前,她接受了全甲状腺切除术和颈部淋巴结清扫术。随访期间颈部超声显示多个淋巴结肿大。此外,血清降钙素跃升至198.17 pg/mL,强烈提示MTC复发。随后,通过超声引导下细针穿刺细胞学检查和细针穿刺降钙素检查确诊了两个转移性淋巴结,然后对患者进行了RFA治疗。四个月后,颈部超声和超声造影显示消融区明显缩小,血清降钙素降至11.80 pg/mL。
该病例表明RFA可能是局部复发性MTC的一种有效且安全的治疗方法。