Thyroid nodule rupture after radiofrequency ablation: case report and literature review
Tatiana Ferraro1,2, Sameeha Sajid2, Steven P Hodak3
1Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States.
Purpose:
Radiofrequency ablation (RFA) is an effective and safe modality for the treatment of thyroid nodules. Nodule rupture is a major complication of RFA. There is little known on the natural history of nodule rupture due to a lack of clinical experience and no consensus on its management. A comprehensive review of nodule rupture presentation, diagnosis, and management is needed.
Methods:
We report a case of nodule rupture and conduct a literature review. A total of 33 patients experiencing nodule rupture after RFA were included, and their clinical presentation, management, and outcomes were collected and analyzed.
Results:
Nodule rupture presents with acute swelling (90.3%) and pain (77.4%) within 7 months of RFA procedure, most commonly due to disruption of the anterior thyroid capsule (87%), and can be diagnosed with ultrasonography. Most ruptures can be managed conservatively, exemplified by our reported case. There are no reported cases of long-term sequalae.
Conclusion:
Nodule rupture is the second most common major complication of RFA. Based on the available evidence, we propose a treatment algorithm for nodule rupture and recommendations for future data collection to address gaps in our understanding of rupture etiology and effective management.
