Radiofrequency ablation of hepatic metastases from thyroid carcinoma.

BACKGROUND: Radiofrequency ablation (RFA) is performed for various types of liver tumors. It might also have a role in the palliative treatment of liver metastases from thyroid carcinoma.

SUMMARY: Three patients with liver metastases of thyroid carcinoma were retrieved from our database of 125 patients who had been treated with RFA for liver tumors. In all three patients, the metastases were a sign of widespread disease, and several other treatment modalities had been performed earlier. Two patients had metastases from medullary thyroid carcinoma and had severe diarrhea. The third patient had a rapidly progressive metastasis of a follicular thyroid carcinoma. The aim of the treatment was cytoreduction with amelioration of symptoms (n = 2) and debulking with increased sensitivity for subsequent (131)I treatment. The ablation was performed via laparotomy (n = 1), laparoscopically (n = 1), or percutaneously (n = 1). One patient experienced superficial burn wounds after a long-lasting RFA procedure. Severity of symptoms was reduced significantly after RFA for a prolonged period of time. RFA induced partial tumor necrosis because of hypervascularization of the tumor in one patient. After arterial embolization the second RFA treatment induced total tumor necrosis. Local recurrences at the site of the ablated liver metastases were not encountered during follow-up.

CONCLUSIONS: RFA is a useful treatment modality in patients with liver metastases from thyroid carcinoma. It should be considered an adjunct to other types of treatment or for those patients in whom more regular treatment modalities are not effective or possible or are associated with increased risks.