Radiofrequency Ablation of Primary Parathyroid Adenoma: Preliminary Results for Patients Ineligible for Surgery
- Presentation Speakers / Moderators
Purpose: To retrospectively evaluate the outcomes of ultrasonography (US)-guided radiofrequency ablation (RFA) of parathyroid adenoma in patients who were ineligible for surgery.
Materials and Method: Ten parathyroid adenomas (mean diameter, 2.0 cm; range, 1.2-3.8 cm) in nine patients with primary hyperparathyroidism were treated with US-guided RFA. The inclusion criteria were (1) primary hyperparathyroidism, (2) pathologically confirmed parathyroid adenoma on US-guided FNA, and (3) refusal- or ineligibility- for surgery. RFA was performed using a RF generator and 19-gauge internally cooled electrode. The hydrodissection technique using the 5% DW was applied in all patients. The medical records were reviewed and analysed, focusing on the procedural profiles of RFA, symptoms and complications during and after RFA, and changes in hormone levels on follow-up US.
Results: Before RFA, the mean nodule volume was 1.3 ± 1.0 mL. The mean PTH level was 121.1 ± 62.2 pg/mL and calcium level was 10.3 ± 0.7 mg/dL. At 1- and 6- month follow-up after RFA, a significant reduction in the mean volume (46.2% and 92.4 %, respectively) was noted and eight ablation zones (8/10, 80.0%) near completely disappeared (<=0.1mL). The mean PTH level was decreased to the normal range (86.5 ± 55.7 pg/mL) at 1-month follow-up and were decreased at 6-month follow-up in 8 patients (61.7 ± 33.3 pg/mL). The mean calcium level was decreased to 8.9 ± 0.4 mg/dL at last follow-up. There was one minor complication (transient hypocalcemia) after the treatment.
Conclusion: RFA might represent an effective and a safe alternative for managing parathyroid adenomas, especialy in patients ineligible for surgery.
Two Approaches to Level 5 Neck Dissection
- Jeff Blumberg