Thyroid nodule rupture after thermal ablation for benign thyroid nodules: incidence, risk factors, and clinical management
Background Thyroid nodule rupture (TNR) is a rare and severe complication after thermal ablation (TA), mostly from benign thyroid nodules (BTN).Objective To summarize the incidence of TNR after TA and analyze the causes and prevention strategies.Materials and methods This retrospective study enrolle...
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Taylor & Francis Group
2025-12-01
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| Series: | International Journal of Hyperthermia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/02656736.2024.2439536 |
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| author | Yu-tong Liu Ying Wei Zhen-Long Zhao Jie Wu Shi-Liang Cao Na Yu Yan Li Li-Li Peng Ming-an Yu |
| author_facet | Yu-tong Liu Ying Wei Zhen-Long Zhao Jie Wu Shi-Liang Cao Na Yu Yan Li Li-Li Peng Ming-an Yu |
| author_sort | Yu-tong Liu |
| collection | DOAJ |
| description | Background Thyroid nodule rupture (TNR) is a rare and severe complication after thermal ablation (TA), mostly from benign thyroid nodules (BTN).Objective To summarize the incidence of TNR after TA and analyze the causes and prevention strategies.Materials and methods This retrospective study enrolled 3971 patients who underwent TA for BTN from January 2014 to March 2024. The incidence, causes, and risk factors of TNR were analyzed. Propensity score matching (PSM) controlled for confounding factors. Multivariate regression identified risk factors for TNR. ROC curves determined the optimal cutoff value for the maximum diameter (MD) for TNR.Results TNR occurred in 8 cases [0.2% (8/3971)]. The mean time from TA to TNR was 29.6 ± 13.0 days (range, 20-60 days). After PSM, MD was larger in the TNR group than in the non-TNR group [mean 4.1 ± 1.6 cm vs. mean 1.8 ± 1.2 cm; p < 0.001]. The optimal cutoff value of MD for TNR was 2.75 cm. After PSM, the incidence of pressure on the ablation zone was significantly higher in the TNR group than in the non-TNR group [100% (8/8) vs. 0 (0/32); p < 0.001], which has been suspected as a case of TNR. Antibiotic drugs, aspiration, or incision drainage could successfully manage all TNR cases.Conclusion TNR could be encountered in case of pressure on the BTN after TA. Protecting the ablation site from pressure might be crucial in preventing TNR, especially within two months. TNR is more likely to occur if the MD of BTN exceeds 2.75 cm under pressure. Observation, antibiotics, and aspiration could successfully manage all TNR cases. |
| format | Article |
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| institution | Kabale University |
| issn | 0265-6736 1464-5157 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
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| series | International Journal of Hyperthermia |
| spelling | doaj-art-bae08972b80a45d29270c1068aabd67c2025-01-06T02:22:17ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572025-12-0142110.1080/02656736.2024.2439536Thyroid nodule rupture after thermal ablation for benign thyroid nodules: incidence, risk factors, and clinical managementYu-tong Liu0Ying Wei1Zhen-Long Zhao2Jie Wu3Shi-Liang Cao4Na Yu5Yan Li6Li-Li Peng7Ming-an Yu8China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Interventional Medicine, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Interventional Medicine, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Interventional Medicine, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Interventional Medicine, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Interventional Medicine, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Interventional Medicine, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Interventional Medicine, China-Japan Friendship Hospital, Beijing, ChinaChina-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences and Peking Union Medical CollegeBackground Thyroid nodule rupture (TNR) is a rare and severe complication after thermal ablation (TA), mostly from benign thyroid nodules (BTN).Objective To summarize the incidence of TNR after TA and analyze the causes and prevention strategies.Materials and methods This retrospective study enrolled 3971 patients who underwent TA for BTN from January 2014 to March 2024. The incidence, causes, and risk factors of TNR were analyzed. Propensity score matching (PSM) controlled for confounding factors. Multivariate regression identified risk factors for TNR. ROC curves determined the optimal cutoff value for the maximum diameter (MD) for TNR.Results TNR occurred in 8 cases [0.2% (8/3971)]. The mean time from TA to TNR was 29.6 ± 13.0 days (range, 20-60 days). After PSM, MD was larger in the TNR group than in the non-TNR group [mean 4.1 ± 1.6 cm vs. mean 1.8 ± 1.2 cm; p < 0.001]. The optimal cutoff value of MD for TNR was 2.75 cm. After PSM, the incidence of pressure on the ablation zone was significantly higher in the TNR group than in the non-TNR group [100% (8/8) vs. 0 (0/32); p < 0.001], which has been suspected as a case of TNR. Antibiotic drugs, aspiration, or incision drainage could successfully manage all TNR cases.Conclusion TNR could be encountered in case of pressure on the BTN after TA. Protecting the ablation site from pressure might be crucial in preventing TNR, especially within two months. TNR is more likely to occur if the MD of BTN exceeds 2.75 cm under pressure. Observation, antibiotics, and aspiration could successfully manage all TNR cases.https://www.tandfonline.com/doi/10.1080/02656736.2024.2439536Thyroid nodule rupturerisk factorsthermal ablationbenign thyroid noduleultrasound |
| spellingShingle | Yu-tong Liu Ying Wei Zhen-Long Zhao Jie Wu Shi-Liang Cao Na Yu Yan Li Li-Li Peng Ming-an Yu Thyroid nodule rupture after thermal ablation for benign thyroid nodules: incidence, risk factors, and clinical management International Journal of Hyperthermia Thyroid nodule rupture risk factors thermal ablation benign thyroid nodule ultrasound |
| title | Thyroid nodule rupture after thermal ablation for benign thyroid nodules: incidence, risk factors, and clinical management |
| title_full | Thyroid nodule rupture after thermal ablation for benign thyroid nodules: incidence, risk factors, and clinical management |
| title_fullStr | Thyroid nodule rupture after thermal ablation for benign thyroid nodules: incidence, risk factors, and clinical management |
| title_full_unstemmed | Thyroid nodule rupture after thermal ablation for benign thyroid nodules: incidence, risk factors, and clinical management |
| title_short | Thyroid nodule rupture after thermal ablation for benign thyroid nodules: incidence, risk factors, and clinical management |
| title_sort | thyroid nodule rupture after thermal ablation for benign thyroid nodules incidence risk factors and clinical management |
| topic | Thyroid nodule rupture risk factors thermal ablation benign thyroid nodule ultrasound |
| url | https://www.tandfonline.com/doi/10.1080/02656736.2024.2439536 |
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