Ultrasound-guided percutaneous microwave ablation for locoregional recurrence of medullary thyroid carcinoma

Objective Medullary thyroid carcinoma (MTC) is a rare, aggressive thyroid malignancy with frequent locoregional recurrence rate at 30–50%. Reoperative neck surgery is standard but challenging and risky. Ultrasound (US)-guided microwave ablation (MWA) offers minimally invasive alternatives, though ev...

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Main Authors: Isa Cam, Almotasem Shatat, Damla Köksalan, Said Atış, Ahmet Yalnız, Özgür Çakır, Alev Selek, Mehmet Sözen, Büşra Yaprak Bayrak, Seda Öztürk, Özge Telci Çakıllı, Nuh Zafer Cantürk, Ercüment Çiftçi
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:International Journal of Hyperthermia
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Online Access:https://www.tandfonline.com/doi/10.1080/02656736.2025.2533305
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author Isa Cam
Almotasem Shatat
Damla Köksalan
Said Atış
Ahmet Yalnız
Özgür Çakır
Alev Selek
Mehmet Sözen
Büşra Yaprak Bayrak
Seda Öztürk
Özge Telci Çakıllı
Nuh Zafer Cantürk
Ercüment Çiftçi
author_facet Isa Cam
Almotasem Shatat
Damla Köksalan
Said Atış
Ahmet Yalnız
Özgür Çakır
Alev Selek
Mehmet Sözen
Büşra Yaprak Bayrak
Seda Öztürk
Özge Telci Çakıllı
Nuh Zafer Cantürk
Ercüment Çiftçi
author_sort Isa Cam
collection DOAJ
description Objective Medullary thyroid carcinoma (MTC) is a rare, aggressive thyroid malignancy with frequent locoregional recurrence rate at 30–50%. Reoperative neck surgery is standard but challenging and risky. Ultrasound (US)-guided microwave ablation (MWA) offers minimally invasive alternatives, though evidence in recurrent MTC remains limited. This study evaluated the efficacy and safety of percutaneous US-guided MWA for treating recurrent MTC.Methods A retrospective review included 22 patients with biopsy-proven locoregional recurrent MTC treated by US-guided percutaneous MWA after prior total thyroidectomy. All were either poor surgical candidates or declined reoperation. Thirty-four lesions underwent single-session outpatient ablation. Tumor size, serum calcitonin and volume reduction ratio (VRR) were assessed at baseline, 1, 3, 6 and 12 months post-ablation. Imaging and biochemical responses determined treatment outcomes. Recurrence-free survival between recurrent and non-recurrent groups was compared.Results A total of 22 patients (median age 52 years; 14% hereditary) were included and MWA was successfully performed in all. Mean tumor diameter significantly reduced from 14.3 ± 11.6 mm to 2.6 ± 3.4 mm at 12 months (p < .001). Median serum calcitonin decreased significantly from 1165 pg/mL to 108 pg/mL at 12 months (p < .001). Treated lesions showed no regrowth; however, 50% developed new metastases elsewhere, correlating with higher initial metastatic burden (p = .001) and higher baseline calcitonin (p = .037).Conclusion US-guided MWA effectively reduces tumor volume and calcitonin levels in recurrent MTC with minimal morbidity, though close surveillance for new metastases remains essential.
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series International Journal of Hyperthermia
spelling doaj-art-07d0ed83b6cc43729d2ae3a15e1e90ef2025-08-20T02:40:07ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572025-12-0142110.1080/02656736.2025.2533305Ultrasound-guided percutaneous microwave ablation for locoregional recurrence of medullary thyroid carcinomaIsa Cam0Almotasem Shatat1Damla Köksalan2Said Atış3Ahmet Yalnız4Özgür Çakır5Alev Selek6Mehmet Sözen7Büşra Yaprak Bayrak8Seda Öztürk9Özge Telci Çakıllı10Nuh Zafer Cantürk11Ercüment Çiftçi12Department of Radiology, Division of Interventional Radiology, Kocaeli University, Kocaeli, TurkeyDepartment of Radiology, Division of Interventional Radiology, Kocaeli University, Kocaeli, TurkeyDepartment of Endocrinology, Kocaeli University, Kocaeli, TurkeyDepartment of Radiology, Division of Interventional Radiology, Kocaeli University, Kocaeli, TurkeyDepartment of Radiology, Division of Interventional Radiology, Kocaeli University, Kocaeli, TurkeyDepartment of Radiology, Division of Interventional Radiology, Kocaeli University, Kocaeli, TurkeyDepartment of Endocrinology, Kocaeli University, Kocaeli, TurkeyDepartment of Endocrinology, Kocaeli University, Kocaeli, TurkeyDepartment of Clinical Pathology, Kocaeli University, Kocaeli, TurkeyDepartment of Clinical Pathology, Kocaeli University, Kocaeli, TurkeyDepartment of Endocrinology, Kocaeli City Hospital, Kocaeli, TurkeyDepartment of General Surgery, Kocaeli University, Kocaeli, TurkeyDepartment of Radiology, Division of Interventional Radiology, Kocaeli University, Kocaeli, TurkeyObjective Medullary thyroid carcinoma (MTC) is a rare, aggressive thyroid malignancy with frequent locoregional recurrence rate at 30–50%. Reoperative neck surgery is standard but challenging and risky. Ultrasound (US)-guided microwave ablation (MWA) offers minimally invasive alternatives, though evidence in recurrent MTC remains limited. This study evaluated the efficacy and safety of percutaneous US-guided MWA for treating recurrent MTC.Methods A retrospective review included 22 patients with biopsy-proven locoregional recurrent MTC treated by US-guided percutaneous MWA after prior total thyroidectomy. All were either poor surgical candidates or declined reoperation. Thirty-four lesions underwent single-session outpatient ablation. Tumor size, serum calcitonin and volume reduction ratio (VRR) were assessed at baseline, 1, 3, 6 and 12 months post-ablation. Imaging and biochemical responses determined treatment outcomes. Recurrence-free survival between recurrent and non-recurrent groups was compared.Results A total of 22 patients (median age 52 years; 14% hereditary) were included and MWA was successfully performed in all. Mean tumor diameter significantly reduced from 14.3 ± 11.6 mm to 2.6 ± 3.4 mm at 12 months (p < .001). Median serum calcitonin decreased significantly from 1165 pg/mL to 108 pg/mL at 12 months (p < .001). Treated lesions showed no regrowth; however, 50% developed new metastases elsewhere, correlating with higher initial metastatic burden (p = .001) and higher baseline calcitonin (p = .037).Conclusion US-guided MWA effectively reduces tumor volume and calcitonin levels in recurrent MTC with minimal morbidity, though close surveillance for new metastases remains essential.https://www.tandfonline.com/doi/10.1080/02656736.2025.2533305Medullary thyroid carcinomamicrowave ablationthermal ablationultrasound-guided ablationrecurrent thyroid cancer
spellingShingle Isa Cam
Almotasem Shatat
Damla Köksalan
Said Atış
Ahmet Yalnız
Özgür Çakır
Alev Selek
Mehmet Sözen
Büşra Yaprak Bayrak
Seda Öztürk
Özge Telci Çakıllı
Nuh Zafer Cantürk
Ercüment Çiftçi
Ultrasound-guided percutaneous microwave ablation for locoregional recurrence of medullary thyroid carcinoma
International Journal of Hyperthermia
Medullary thyroid carcinoma
microwave ablation
thermal ablation
ultrasound-guided ablation
recurrent thyroid cancer
title Ultrasound-guided percutaneous microwave ablation for locoregional recurrence of medullary thyroid carcinoma
title_full Ultrasound-guided percutaneous microwave ablation for locoregional recurrence of medullary thyroid carcinoma
title_fullStr Ultrasound-guided percutaneous microwave ablation for locoregional recurrence of medullary thyroid carcinoma
title_full_unstemmed Ultrasound-guided percutaneous microwave ablation for locoregional recurrence of medullary thyroid carcinoma
title_short Ultrasound-guided percutaneous microwave ablation for locoregional recurrence of medullary thyroid carcinoma
title_sort ultrasound guided percutaneous microwave ablation for locoregional recurrence of medullary thyroid carcinoma
topic Medullary thyroid carcinoma
microwave ablation
thermal ablation
ultrasound-guided ablation
recurrent thyroid cancer
url https://www.tandfonline.com/doi/10.1080/02656736.2025.2533305
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