Incomplete ablation of thyroid cancer: Achilles' Heel?

IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM BMC Endocrine Disorders Pub Date : 2024-08-09 DOI:10.1186/s12902-024-01659-5
Ze Yang, Xue-Hua Pan, Heng-Tong Han, Yong-Xun Zhao, Li-Bin Ma
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Abstract

Background: In recent years, the incidence of thyroid nodules has increased significantly. There are various ways to treat thyroid nodules, and ablation therapy is one of the important ways to treat thyroid nodules. However, there are many complications and deficiencies in the current ablation treatment of thyroid nodules, especially the incomplete ablation of thyroid cancer nodules, which limits the further application of ablation technology. In this paper, we report two cases of incomplete ablation of thyroid nodules, one of which underwent surgical treatment due to anxiety after ablation, and the postoperative pathology confirmed that there was still residual papillary thyroid carcinoma, and the other patient underwent an operation after ablation, but visited our medical institution again due to cervical lymph node metastasis in a short period of time, and after radical cervical lymph node dissection, pathology confirmed multiple cervical lymph node metastasis. Radionuclide therapy was performed after surgery, and two patients are currently receiving endocrine suppression therapy, and their condition is stable with no signs of recurrence.

Conclusion: The incomplete ablation of thyroid cancer nodules limits the development of ablation therapy, making ablation treatment a double-edged sword. Guidelines and expert consensus can guide their development, but they need to evolve with the times, and a multidisciplinary diagnostic team can help screen the most suitable patients. Only by using this technology more standardly, using the most appropriate technology, and treating the most suitable patients, can benefit more and more patients.

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甲状腺癌的不完全消融:致命弱点?
背景:近年来,甲状腺结节的发病率明显上升。治疗甲状腺结节的方法多种多样,消融治疗是治疗甲状腺结节的重要方法之一。但目前消融治疗甲状腺结节存在很多并发症和不足,尤其是甲状腺癌结节消融不彻底,限制了消融技术的进一步应用。本文报告了两例甲状腺结节不完全消融病例,其中一例患者消融后因焦虑接受手术治疗,术后病理证实仍有甲状腺乳头状癌残留;另一例患者消融后接受手术治疗,但短时间内因颈淋巴结转移再次就诊,行根治性颈淋巴结清扫术后,病理证实多发颈淋巴结转移。术后进行了放射性核素治疗,目前两名患者正在接受内分泌抑制治疗,病情稳定,无复发迹象:结论:甲状腺癌结节的不完全消融限制了消融治疗的发展,使消融治疗成为一把双刃剑。指南和专家共识可以指导其发展,但也需要与时俱进,多学科诊断团队可以帮助筛选出最合适的患者。只有更规范地使用这项技术,使用最合适的技术,治疗最合适的患者,才能让越来越多的患者受益。
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来源期刊
BMC Endocrine Disorders
BMC Endocrine Disorders ENDOCRINOLOGY & METABOLISM-
CiteScore
4.40
自引率
0.00%
发文量
280
审稿时长
>12 weeks
期刊介绍: BMC Endocrine Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of endocrine disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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