Patient Profiles

Patient Profiles
April 21, 2024

Case 1

OPERATING ROOM #N/A
OPERATING ROOM #N/A

– Persistence of multiple small hypoechoic plus spongiform nodules measuring up to 1.5 cm at right lobe
– No cervical node enlargement.

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Case 2

OPERATING ROOM #N/A
OPERATING ROOM #N/A
Female
60

– Few TIRADS4 nodules at lower pole of right lobe (0.29×0.19 cm), isthmus (0.41×0.40) and upper
pole of left lobe (0.65×0.47×0.93 cm).
– Multiple colloid cysts and simple cysts scattered at bilateral thyroid lobes, largest at lower pole of left lobe- measures up to 1.42cm.

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Case 3

OPERATING ROOM #N/A
OPERATING ROOM #N/A
Female
28

– A0.9-m hypoechoic nodule with cystic component at mid pole of the right thyroid lobe; TR4. – Multiple cystic-solid and cystic nodules in both lobes.
– No cervical lymphadenopathy.

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Case 4

OPERATING ROOM #N/A
OPERATING ROOM #N/A
Male
64

– A3.3×2.7×2.1-cm mixed cystic and solid hypoechoic nodule at right mid thyroid,
TR3 (3 points).
– Three small subcentrimeter spongioform nodules; two nodules at right lobe and one at isthmus.

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Case 5

OPERATING ROOM #N/A
OPERATING ROOM #N/A
Female
64

Clinical information: Right thyroid nodule

Findings:
Background thyroid: normal size and echogenicity without significant increased vascularity
Nodules:
– A mixed cystic and solid isoechoic mass at mid pole of right lobe with punctate echogenic foci, size 2.19×1.65×2.74 cm: ACR TI-RADS 4
– A solid hypoechoic lesion at mid pole of right lobe, size 0.40×0.44×0.53 cm: ACR TI-RADS 4
– A solid hypoechoic lesion at upper pole of left lobe, size 0.49×0.26×0.44 cm: ACR TI-RADS 4
– Few cysts and spongiform nodules in both lobes
Lymph node: No significant cervical lymphadenopathy

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Case 6

OPERATING ROOM #N/A
OPERATING ROOM #N/A

– A 1.2×1.22.5-cm mixed solid-cystic hypoechoic nodule with macrocalcification at mid pole of
left lobe. TR4.

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Case 7

OPERATING ROOM #N/A
OPERATING ROOM #N/A
Female

Exam Date: 30/11/2023

The study redemonstrates multiple scattered nodules at both lobes of the thyroid glands. There si
no substantial change of three significant nodules at both lobes as described below;

  1. An ill-defined spongiform heterogeneous-hypoechoic lesion with wider-than-tall appearance without internal calcification at the lower pole of the right thyroid lobe. approximately measuring 0.7 x 1.0 x 1.3 cm in AP x TRV × SI. This lesion is categorized as TI-RADS 2, not suspicious.
  2. An ill-defined spongiform heterogeneous-isoechoic lesion with wider-than-tall appearance without internal calcification at the lower pole of the left thyroid lobe, approximately
    measuring 0.8 x 0.9 × 1.0 cm in AP × TRV × SI. This lesion is categorized as TI-RADS 2. not suspicious.
  3. Another ill-defined spongiform heterogeneous-hypoechoic lesion with wider-than-tall
    appearance without internal calcification at the middle pole of the left thyroid lobe. approximately measuring 0.7 × 1.2 × 1.6 cm in AP x TRV x SI.This lesion is categorized as TI-RADS 2, not suspicious
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Case 8

OPERATING ROOM #N/A
OPERATING ROOM #N/A
Female
70

– Increase in size of TIRADS 4 mix solid-cystic nodule at upper pole of right lobe, 1.28×0.82×2.07
cm.
– No significant change of nodules at lower pole of right and left lobes, as described.
– Few cysts at bilateral lobes of thyroid.

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Case 9

OPERATING ROOM #N/A
OPERATING ROOM #N/A
Female

– Increased size of the 4.8×3.5×5-cm (from 2.4×2.5×4.5 cm) mixed cystic/solid nodule,
occupying almost the entire right lobe
– No change of the other 0.7-cm mixed cystic/solid nodule at upper pole of the right
lobe.
– No change of a 0.3-cm cyst at mid pole of the left lobe.
– No cervical node enlargement.

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Case 10

OPERATING ROOM #N/A
OPERATING ROOM #N/A
Male
69

– Parenchymatous disease right thyroid lobe.
– Multiple thyroid nodules;

  • Increased number of multiple TR4 nodules scattered in the right lobe with no change in size of the largest (0.6 cm) nodule, moderately suspicious.
  • Nodules in the left lobe now seen as TR4 nodules with macrocalcification and increased vascularity at the upper pole (1.2-cm and 1.4-cm) and mid pole (0.8-cm), moderately suspicious. Fine Needle Aspiration (FNA) of the largest nodule is advised.
  • A few cysts in both lobes of the thyroid gland.

– 0.4-cm lymph node with thickened cortex at left upper cervical region.
– Mild parenchymatous disease of bilateral submandibular glands is suggested.

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BONUS DAY: APRIL 22, 2024
Hosted by PRARAM 9 Hospital

In-person ablation procedures performed by Dr. Thanyawat Sasanakietkul. Followed by roundtable discussion. Dr. Thanyawat Sasanakietkul is the first doctor to perform thyroid ablation in Thailand and has treated 100+ patients.