First successful radiofrequency ablation for papillary thyroid microcarcinoma in Indonesia: a case report

Papillary thyroid microcarcinoma (PTMC) is the most common subtype of thyroid cancer, generally associated with a favorable prognosis. Radiofrequency ablation (RFA) is emerging as a minimally invasive alternative to surgery, particularly for patients unsuitable for active surveillance and surgery. This report presents the first documented case of RFA for PTMC in Indonesia.

A 40-year-old woman presented with a palpable thyroid nodule on the right side of her neck. Thyroid ultrasound and thyroid core needle biopsy confirmed PTMC. The patient underwent RFA using a 5-mm probe tip and 50-Watt power, employing the "moving shot" technique. The procedure was successful, with no reported complications. Follow-up assessments showed a significant reduction in tumor volume of 95.38%, from 0.264 ml to 0.012 ml, with no signs of progression at 12 months.

RFA provides a minimally invasive alternative to active surveillance with advantages, giving patient definitive treatment. Compare to surgery, this treatment have advantage such as shorter procedure time, lower procedural costs, reduced blood loss, and preservation of thyroid function, leading to faster recovery. However, wider adoption in Indonesia remains limited by the need for trained operators and access to advanced ultrasonography equipment. Strengthening workforce training, improving infrastructure, and generating long-term outcome data are essential for broader implementation.

This case highlights RFA as a safe and effective treatment for PTMC, particularly for patients who do not wish to undergo active surveillance management for low risk thyroid cancer. Further studies are necessary to assess its long-term efficacy and feasibility.