Calcification Did Not Limit Thyroid Microcarcinoma Ablation Outcomes in Retrospective Cohort

Intratumoral calcification may complicate imaging assessment after radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC). A retrospective study published in Thyroid evaluated 258 consecutive patients with low-risk, unifocal PTMC treated with RFA between November 2017 and August 2022. Of these, 94 tumors had calcifications and 164 did not. Primary outcomes were technical success and calcification disappearance by pattern; mean follow-up was 53.5 ± 16.7 months.

Technical success was achieved in all patients. Mean volume reduction exceeded 90% by 18 months in both groups, and all tumors reached 100% volume reduction at final follow-up of at least 36 months. Calcifications disappeared in 90 of 94 tumors (95.7%): 100% with microcalcifications, 92.9% with rim calcifications, and 75.0% with macrocalcifications. Mean resolution time was shortest for microcalcifications (12.0 months) and longest for rim calcifications (24.8 months; p < 0.001).

Disease progression involving lymph node metastases occurred in one patient (0.4%), while 15 patients (5.8%) developed new PTC in the remaining thyroid; rates did not differ significantly by calcification status. One patient experienced transient hoarseness, with no major or delayed complications reported. These findings suggest calcification alone need not preclude effective RFA in selected low-risk PTMC. However, the retrospective design, small calcification subgroups, and absence of a non-RFA comparator limit conclusions about comparative efficacy. Only the abstract was available for assessment.