Radiofrequency Ablation a Safe and Effective Treatment for Pediatric Benign Nodular Thyroid Goiter

Purpose: To evaluate the effectiveness of radiofrequency ablation (RFA) for benign thyroid nodules in pediatric patients.Materials and Methods: Twelve pediatric patients (11 female, 1 male; mean age 15.54 +/- 2.8 years, range 10-19 years) with benign thyroid nodules (mean longest diameter 4.1 +/- 1.4 cm, range 1.5-5.9 cm) treated by RFA from 2017 to 2020 were evaluated. The inclusion criteria for RFA therapy were (i) age < 20 years; (ii) benign cytological confirmation by 2 separate ultrasound guided fine-needle aspiration cytology (FNAC) or core needle biopsies; (iii) pressure symptoms or cosmetic problems caused by thyroid nodules; (iv) absence of any sonographic suspicious feature; and (v) follow-up for >6 months. Under local anesthesia, RFA was performed with the use of an RF generator and an 18-gauge internally cooled electrode. Volume changes in nodules on follow-up ultrasonography (US), changes in symptomatic and cosmetic scores, and complications arising during or after RFA were evaluated.Results: Mean follow-up period was 24.9 +/- 13.9 months (range 6-43 months). At the last follow-up visits, volume of the nodule had decreased significantly (15.34 +/- 11.52 mL vs. 4.07 +/- 4.99 mL; P < 0.05), whereas volume reduction rate was 74.31% +/- 19.59%. Both cosmetic and compressive symptoms were also significantly improved (2.91 +/- 0.79 vs. 0.92 +/- 0.67 and 1.5 +/- 1.93 vs. 0.17 +/- 0.39; P < 0.05). The mean number of ablation sessions was 1.4 +/- 0.6 (range 1-3 sessions), and one of the patients suffered from transient vocal cord palsy which was spontaneously resolved 53 days later.Conclusions: RFA is a safe and effective treatment for benign thyroid nodules in pediatric patients, and can thus serve as an alternative treatment for thyroidectomy.