Learn About Thyroid Procedures

Few know of the many procedural options in order to avoid thyroid surgery, including  Endocrinologists and Surgeons. That’s why we strive to share our knowledge and communicate clearly and empathetically with all our patients. Here’s a brief explanation of the terms you might hear if you or your loved ones suffer from thyroid conditions:

Radio Frequency Ablation of the Thyroid (RFA)

Dr. Andrade is a pioneer and expert, as well as one of the first 5 doctors in the nation to perform this procedure. This is an innovative outpatient treatment in which  he uses RFA to reduce the size of benign thyroid nodules.

Percutaneous Laser Ablation (PLA)

Dr. Andrade is the first physician to perform this procedure in the USA. As with RFA, Laser Ablation is also a non-surgical outpatient treatment that reduces the size of benign thyroid nodules.

Mapping of Neck Lymph Nodes for Thyroid Cancer

Ultrasound lymph node mapping is necessary before planning a thyroidectomy for Differentiated Thyroid Cancer (DTC) and Medullary Thyroid Cancer. It is a tool for surgical planning and prognosis determination. The mapping predicts the lymphatic spread of the tumor.

This simple, non-invasive procedure works without radiation. And, it is a highly sensitive tool for monitoring disease recurrence after thyroidectomy in conjunction with monitoring Tg levels and sometimes, an I-131 Whole Body Scan (WBS).

Ultrasound of the Thyroid and Parathyroid

Dr. Andrade is an ECNU-certified physician, Dr. Andrade is and has performed more than 30,000 ultrasounds of the neck, thyroid, parathyroid, and lymph nodes. He has found Parathyroid ultrasounds to be the most cost-effective tool to discover the location of parathyroid adenoma in patients with Primary and Tertiary Hyperparathyroidism. The 80% sensitivity and 70% specificity makes this test superior to the Parathyroid Scan, which is the most frequently ordered.

Ultrasound-Guided Fine Needle Aspiration of the Parathyroid (FNA) Needle Wash-out for Parathyroid Assay

Usually, Parathyroid nodules do not require aspirations, except when there is doubt of the diagnosis.  In these cases, a PTH assay from the needle wash-out is performed. When the PTH is high in the sample, this is confirmation the lesion is a Parathyroid.

Alcohol Injections for Thyroid Cysts/ Percutaneous Aspiration and Ethanol Injection (PEI)

One of only a few physicians in the nation who performs this procedure, Dr. Andrade has done hundreds of PEIs over 20 years. And, none of his patients had significant complications after the treatment.

Cystic lesion (simple cyst or partially cystic thyroid) accounts for approximately 10% to 20% of thyroid nodules. Many of these lesions cause local discomfort or cosmetic complaints.  Simple aspiration of a thyroid cyst will have a recurrence rate in about 70% of cases. The aspiration followed by PEI has a success rate of 70% cure or significant shrinkage (>50% reduction).

Aspiration followed by PEI is the first option in Europe and most Asian countries. However, in the  United States, surgery is suggested in the vast majority of symptomatic cysts.

Alcohol Injections of Recurrent Thyroid Cancer in Neck-Lymph Nodes

Differentiated Thyroid Cancer (DTC) is the most common subtype of thyroid cancer and typically has an excellent prognosis. However, postoperative recurrence does occur in 20% to 60% of the cases.

Ethanol Injection of local recurrent thyroid cancer provides a successful reduction or disappearance rate of about  80%. Ethanol Ablation of recurrent tumor is ideal for a localized and small number of lymph nodes. We recommend one to three treatment sessions as an outpatient procedure.

There are few complications, usually minor discomfort. The patient can go home without any restrictions. Our doctor is one of only a few physicians in the nation who performs this procedure.

Ethanol Ablation for Thyroglossal Duct Cysts (TGDC)

Worldwide, our doctor has the distinction of being one of a select few who provides this outpatient procedure. It consists of one to three sessions with a success rate of about 80% volume reduction in a year.

After surgery, there is usually only minor discomfort, which allows the patient to return home without restrictions.

Thyroid Nodules Biopsy / Fine Needle Aspiration of the Thyroid (FNA)

This refers to an abnormal growth of thyroid cells that forms a lump within the gland. Although the vast majority of thyroid nodules are benign (noncancerous), a small proportion does contain thyroid cancer. To diagnose and treat this at the earliest stage, most thyroid nodules require a Fine Needle Aspiration Biopsy.

Thyroid Cancer

For such a small organ, several types of cancer can affect the thyroid. These include:

Papillary Thyroid Cancer is the most common type of all thyroid cancers and can occur at any age. It tends to grow slowly and spread to lymph nodes in the neck, and generally has an excellent outlook.

Follicular Thyroid Cancer makes up about 10% of all thyroid cancers. This cancer can spread to lymph nodes in the neck but is more likely than papillary cancer to spread to distant organs, particularly the lungs and bones.

Medullary Thyroid Cancer accounts for about 2% of all thyroid cancers. Approximately 25% of this type cancer is inherited, and a test for a genetic mutation in the RET proto-oncogene can lead to an early diagnosis and curative surgery.

Hurthle Cell Thyroid Cancer (HCC) Is a rare type of thyroid cancer that accounts for about 5% of thyroid cancers. Minimally invasive, this cancer exhibits a good prognosis where widely invasive HCC tends to metastasize to lymph nodes and distant organs, such as the lungs and bones.

TGDC is the most common congenital neck cyst. Usually, it shows up as a midline neck lump. Aspiration of TGDC has a high recurrence rate of more than 60%. This is why, in the United States, surgery (Sistrunk procedure) is recommended. The recurrence after surgery is 5%, but it has its drawbacks such as hospitalization, general anesthesia, scars, and/or surgical complications.

Anaplastic Thyroid Cancer is the most advanced and aggressive thyroid cancer. Anaplastic thyroid cancer is very rare and is found in less than 2% of patients with thyroid cancer. It most commonly occurs in people over the age of 60 years.

If you have concerns about thyroid cancer, reach out to our practices for answers.