Radiofrequency Ablation for the Treatment of Recurrent or Oligometastatic Parathyroid Cancer

Inclusion Criteria

• Patient is older than 18 years, is not a surgical candidate or refuses to have surgery
• Patient is medically fit to undergo local anesthesia with or without conscious sedation
• Patient is able to understand and give consent to participation in the study
• Confirmed parathyroid carcinoma by prior surgery and histopathology
• Presence of local recurrence or implant in the neck visible on ultrasound
• Distant oligometastasis visible on ultrasound
• Solid nodule without macrocalcification or internal cystic degeneration
• Patient who is off of cinacalcet
• Entirety of the selected nodule is visible on ultrasound without significant extension posterior to trachea or mediastinal component (ie type A, E, or high F)
• Selected nodule is amenable to medial or lateral approach
• Normal complete blood count, blood coagulation
• Patient agrees to participate in the clinical study and to complete all required visits and evaluations
• Negative serum or urine pregnancy test for females of childbearing potential at baseline pre-procedure evaluation

Exclusion Criteria

• Patients with cardiac arrhythmia and/or implanted cardiac device
• Surgically naïve parathyroid lesions, parathyroid adenoma or atypical parathyroid tumor
• Pregnancy
• Allergies to medications for anesthesia
• Cystic nodules (< 70% solid components)
• Calcified nodules
• Targeted nodule within 0.5 cm from the major vessels, vagus nerve, brachial plexus, and recurrent laryngeal nerve
• Patients with contralateral vocal cord paralysis
• Uncorrectable coagulopathy with partial thromboplastin time (PTT) > 1.5 x upper limit of normal (ULN) or international normalized ratio (INR) > 1.5 or platelet count < 100,000 per mm^3