Introduction: The objective of this study was to compare the efficiency of microwave ablation (MWA) and Radioactive iodine (RAI) in the treatment of toxic adenoma (TA), and investigate functional treatment success of the used modalities for their remission. Material and methods: Treatment outcomes as thyroid hormone levels and nodule characteristics of 30 patients (23:7 F:M; 52.77 ± 11.13 years) treated by MWA were compared with the those of 35 patients (24:11 F:M; 61.43 ± 12.60 years) treated by RAI. The baseline characteristics of TAs, which are gender and pre volume, were analogous and did not show any statistically significances (P >0.05). Thyroid hormone levels of patients treated with two different methods were measured after nine months, and the obtained results were compared. Results: Although there was no statistically significant difference at the nodule volume (P >0.05), there was a greater volume reduction rate (VRR%) in the group treated with MWA rather than RAI (P <0.05) at the end of the follow up. In MWA group, there was a higher increase in FT3 than in RAI group (P <0.05). Furthermore, there could not be observed any statistically significant difference in TSH (P = 0.124) and FT4 (P = 0.144) levels of the patients as treatment outcomes. The therapeutic success of MWA group was accomplished in 18/30 (60%) while those of RAI group in 24/35 (68.6%). Conclusions: Therapeutic success of MWA and RAI was not displayed statistically significant difference (P = 0.471). However, the development of hypothyroidism in 7 of 35 patients treated with RAI was observed. On the other hand, no case of post‐treatment hypothyroidism was observed in patients treated with MWA. In this regard, MWA could be a great alternative of the RAI due to its advantages in terms of non-exposure of radiation and lower risk of post‐treatment hypothyroidism. Introduction: The objective of this study was to compare the efficiency of microwave ablation (MWA) and Radioactive iodine (RAI) in the treatment of toxic adenoma (TA), and investigate functional treatment success of the used modalities for their remission. Material and methods: Treatment outcomes as thyroid hormone levels and nodule characteristics of 30 patients (23:7 F:M; 52.77 ± 11.13 years) treated by MWA were compared with the those of 35 patients (24:11 F:M; 61.43 ± 12.60 years) treated by RAI. The baseline characteristics of TAs, which are gender and pre volume, were analogous and did not show any statistically significances (P >0.05). Thyroid hormone levels of patients treated with two different methods were measured after nine months, and the obtained results were compared. Results: Although there was no statistically significant difference at the nodule volume (P >0.05), there was a greater volume reduction rate (VRR%) in the group treated with MWA rather than RAI (P <0.05) at the end of the follow up. In MWA group, there was a higher increase in FT3 than in RAI group (P <0.05). Furthermore, there could not be observed any statistically significant difference in TSH (P = 0.124) and FT4 (P = 0.144) levels of the patients as treatment outcomes. The therapeutic success of MWA group was accomplished in 18/30 (60%) while those of RAI group in 24/35 (68.6%). Conclusions: Therapeutic success of MWA and RAI was not displayed statistically significant difference (P = 0.471). However, the development of hypothyroidism in 7 of 35 patients treated with RAI was observed. On the other hand, no case of post‐treatment hypothyroidism was observed in patients treated with MWA. In this regard, MWA could be a great alternative of the RAI due to its advantages in terms of non-exposure of radiation and lower risk of post‐treatment hypothyroidism.

Purpose/Aim of the study: Acquired partial lipodystrophy (APL) is a rare disease characterized by selective loss of adipose tissue. In this study, we aimed to present a subset of patients with APL, who developed severe metabolic abnormalities, from our national lipodystrophy registry. Materials and Methods: Severe metabolic abnormalities were defined as: poorly controlled diabetes (HbA1c above 7% despite treatment with insulin more than 1 unit/kg/day combined with oral antidiabetics), severe hypertriglyceridemia (triglycerides above 500 mg/dL despite treatment with lipid-lowering drugs), episodes of acute pancreatitis, or severe hepatic involvement (biopsy-proven non-alcoholic steatohepatitis (NASH)). Results: Among 140 patients with all forms of lipodystrophy (28 with APL), we identified 6 APL patients with severe metabolic abnormalities. The geometric mean for age was 37 years (range: 27–50 years; 4 females and 2 males). Five patients had poorly controlled diabetes despite treatment with high-dose insulin combined with oral antidiabetics. Severe hypertriglyceridemia developed in five patients, of those three experienced episodes of acute pancreatitis. Although all six patients had hepatic steatosis at various levels on imaging studies, NASH was proven in two patients on liver biopsy. Our data suggested that APL patients with severe metabolic abnormalities had a more advanced fat loss and longer disease duration. Conclusions: We suggest that these patients represent a potential subgroup of APL who may benefit from metreleptin or investigational therapies as standard treatment strategies fail to achieve a good metabolic control.

Objective: To explore the alterations of neutrophil-to-lymphocyte ratio (NLR) as a systemic inflammatory marker after microwave ablation for benign thyroid nodules. Study Design: A descriptive study. Place and Duration of Study: Department of Radiology, Antalya Training and Research Hospital, from December 2018 to June 2019. Methodology: Demographic data of the patients, ultrasonographic features of the nodules, thyroid function tests of the patients, leukocyte, neutrophil, lymphocyte values, and thyroid nodule volumes of the patients before and after the procedure were recorded. NLR and volume reduction ratio (VRR %) of 35 patients with thyroid nodules were compared before and after microwave ablation therapy of the thyroid nodules. Results: The nodule volume decreased from 23.89 +/- 15.44 cc to 11.57 +/- 8.65 cc at two months and to 7.79 +/- 5.74 cc at six months. The VRR% increased from 38.65 +/- 16.82 to 63.16 +/- 14.19 at three months and to 68.29 +/- 11.80 at six months. The mean value of NLR decreased from 2.28 +/- 0.86 to 1.78 +/- 0.54. ROC curve analysis suggested that the optimum pre-NLR cut-off point for 50% VRR success was 2.50 with the specifity and sensitivity of 0.67 and 0.50. Conclusion: After ultrasound-guided microwave ablation of benign thyroid module, VRR percentage increased significantly, while the inflammatory marker NLR value decreased.