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Benign Thyroid Nodule Laser Ablation

  • Enrico Papini
  • Rinaldo Guglielmi
  • Agnese Persichetti
  • Claudio Maurizio Pacella
Chapter

Abstract

Surgery is the traditional treatment for thyroid nodules that keep growing over time and are associated with local symptoms. Yet, the direct and indirect expenses due to thyroidectomy and its long-term consequences, the risk of temporary or permanent complications, and the potential adverse influence on the quality of life are important concerns. Due to these considerations, a few image-guided minimally invasive procedures have been proposed for an office-based treatment of nodules that even if benign thyroid nodules are symptomatic or cause cosmetic concern. Among these techniques, US-guided laser thermal ablation (LA) is the most thoroughly assessed and is currently an easy accessible procedure in several thyroid specialized centers in Europe and Asia.

In solid nonfunctioning thyroid nodules, a laser ablation session results in a volume shrinkage that usually ranges from 60% to 80%, followed by the improvement of pressure symptoms. LA is effective for the management of small-size hyperfunctioning nodules that are associated with incomplete suppression of the surrounding thyroid tissue. So this treatment is not followed by irradiation or loss of thyroid function and is especially appealing in young patients. On the other hand, repeated LA treatments are needed to normalize thyroid function in large-size hyperfunctioning lesions. Thus, for these nodules, LA is indicated only as a combined treatment with radioiodine in order to attain a more rapid volume decrease. Notably, these treatments do not require general anesthesia and do not result in any damage to the skin and cervical structures.

Keywords

Minimally invasive procedures Percutaneous image-guided therapy Thermal therapy Laser ablation Thyroid nodules 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Enrico Papini
    • 1
  • Rinaldo Guglielmi
    • 1
  • Agnese Persichetti
    • 1
  • Claudio Maurizio Pacella
    • 2
  1. 1.Department of Endocrinology and MetabolismRegina Apostolorum HospitalAlbano LazialeItaly
  2. 2.Department of Diagnostic Imaging and Interventional RadiologyRegina Apostolorum HospitalAlbano LazialeItaly

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