Thermal Ablation for Benign Thyroid Nodules and Papillary Thyroid Microcarcinoma
Authors:   Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Zhang Daqi ,   Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Jilin, China, Sun Hui ,   Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University; Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Jilin, China, Ierardi Anna Maria ,   Diagnostic and Interventional Radiology Department, IRCCS Ca' Granda Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy, Angileri Salvatore Alessio ,   Diagnostic and Interventional Radiology Department, IRCCS Ca' Granda Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy, Frattini Francesco ,   Division of Surgery, Istituto Auxologico Italiano IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Milan, Italy, Mortellaro Simone ,   Postgraduate School of Radiodiagnostics, Univrsity of Milan, Milan, Italy, Ceriello Arianna ,   Postgraduate School of General Surgery, University of Milan, Milan, Italy, Spisani Jerry ,   Postgraduate School of General Surgery, University of Milan, Milan, Italy, Donatini Gianluca ,   Postgraduate School of General Surgery, University of Milan, Milan, Italy, Dionigi Gianlorenzo ,   Department of General and Endocrine Surgery, Centre Hospitalier Universitaire de Poitiers, Poitiers, France, Carrafiello Giampaolo ,   Diagnostic and Interventional Radiology Department, IRCCS Ca' Granda Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
Published: September 2024

Ultrasound-guided minimally invasive thermoablative (MIT) therapies are a therapeutic option for selected patients with large, hypoenhancing, benign thyroid nodules that cause compression disorders or aesthetic discomfort. MIT, which does not require general anaesthesia, causes thermal necrosis of the treated nodule, which is reduced in size by 50 % without functional consequences, and is indicated for patients who are not too young or in the presence of anaesthesia-related risk factors or recurrence following thyroidectomy or refusal of surgery. For the above indications, MIT complements surgery but does not replace it; it must always be performed in centres and by surgeons with proven technical skills and clinical experience. Subject to appropriate informed consent, the treatment is short-duration, well-tolerated by the patient, safe, and non-invasive. It does not require anaesthesia and complications are rare and transient. MIT, and in particular laser-based procedures (TAL), can also be effective and safe for the treatment of potentially destructible papillary microcarcinoma, as shown by the limited but sufficient literature, including the most recent guidelines, which consider it to be a therapeutic alternative that requires a better understanding of its efficacy and safety.