RFA cases of our Institute

Patient with pronounced keloid tendency

before RFA. 64-year-old female patient with very large 50% cystic nodule, nodule volume right 169 ml (normal volume of right lobe approx. 10 ml). Thyroid surgery rejected due to tendency of proliferating scar formation.

before RFA – lateral view of neck

3 months after RFA the nodule volume is 33 ml (corresponds to a reduction of 80% compared to before RFA)

3 months after RFA – the information about the excessive scarring was not exaggerated, as one can see a small scarring despite only injury to the skin with an approx. 1.5 mm thin probe. This would have looked different after an operation.

The nodule has become smaller by that much: 136 ml. Measured ball sizes (from the handicraft shop) illustrate the extent of the reduction.

3 years following RFA

nodule volume: 3.5 ml (- 83%)
nodule is no longer visible
complaints: grade 0 (of 10)

female patient with “hot” (or “autonomous”/”toxic”) nodule

before RFA – 33-year-old mother of 4 children, refuses radioiodine therapy (treatment with radioactive iodine) because of the children at home, surgery is also not an option for the patient. Hot lump on the right side, about 8 ml and cystic changes.

3 Mon after RFA, the volume of the treated nodule is 1.5 ml (-80% size reduction). The nodule has thus already shrunk noticeably.

12 Mon after RFA: Nodule volume is 0.3 ml (-97% size reduction). The normal thyroid tissue has now regained its volume, the dark “spot” is only a tiny remnant of connective tissue.

TSH is 0.31 IU/L while on 10 mg thiamazole daily. For 3 years she has been taking tablets to slow down hyperthyroidism. In the thyroid scan only the hot nodule shows up on the right, there is no activity detectable on the left side.

3 months after RFA: TSH is normal with 1.48 ( without tablets), the treated area on the right now looks much more like a normal thyroid lobe, on the left side again normal tracer uptake.

12 months after RFA: TSH is 1.58 (normal thyroid function), practically normalized distribution in this thyroid functional image (thyroid scan) in both thyroid lobes.

Patient with large “predominantly cystic” nodule

before RFA – 42 year old female patient, cystic nodule has been known for 6 years, originally punctured, then improvement and further waiting. 5 days before presentation at our clinic sudden enlargement of the lump to 83 ml. Clear symptoms (8 out of 10 on scale).

before RFA – view of the neck, distinct swelling visible at the front and sides

6 months after RFA. Decrease of nodule volume to 5 ml, after 1 year to 1 ml and after 3 years to 0.2 ml corresponding to minus 99% in nodule size compared to before RFA. Normal thyroid function at all times.

6 months after RFA. Again a view of the lateral neck (with the same earrings).

24-year old female patient with large “solid” nodule

before RFA

3 months after RFA

12 months after RFA

marked reductions in nodule size and changes of ultrasound nodule appearance

before RFA – solid 40 ml nodule, complaints 4 out of 10 points. Nodule clearly visible, multiple surgery recommendations.

12 months after RFA (same nodule as left) – nodule volume 8.2 ml (minus 80%). The exact setting of the measuring marks is important to exactly describe the course of the nodule volume dynamics

before RFA – in front to the trachea located 10 ml large cystic node (so-called “colloid cyst” with extremely viscous content comparable to “honey”). Complaints 4 of 10, surgery recommended.

12 months after RFA (same nodule as left). Remaining nodule volume 1.2 ml (minus 89% compared to before RFA), complaints 0 of 10, nodule is no longer visible, normal function is maintained.

61-year-old female patient with a nodule in front of the trachea

61-year-old female patient, nodule volume before RFA 13 ml, after 3 months 5.3 ml, after 12 months 2 ml and after 3 years 1 ml (decrease of 92% to before RFA). Example shows measured nodule volume – depicted by balls of approximate volumes. Left – nodule before, right nodule after 3 years

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