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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleHead and Neck ImagingC

Rupture of Benign Thyroid Tumors after Radio-Frequency Ablation

J.H. Shin, S.L. Jung, J.H. Baek and J.-h. Kim
American Journal of Neuroradiology December 2011, 32 (11) 2165-2169; DOI: https://doi.org/10.3174/ajnr.A2661
J.H. Shin
aFrom the Department of Radiology and Center for Imaging Science (J.H.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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S.L. Jung
bDepartment of Radiology (S.L.J.), Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea
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J.H. Baek
cDepartment of Radiology and Research Institute of Radiology (J.H.B.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea, Department of Radiology and Thyroid Center (J.H.B.), Daerim St. Mary's Hospital, Seoul, Korea
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J.-h. Kim
dDepartment of Radiology (J.-h.K.), Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
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    Fig 1.

    Patient 1. BTT of the left thyroid gland in a 28-year-old man. A, A mixed echoic tumor (dotted lines) of the left thyroid gland is treated with RFA twice. He had a sudden swelling and pain on the left side of his neck 50 days after the second RFA. B, Rupture (arrow) of the tumor is diagnosed by sonography. He was monitored with no invasive procedures. C, Follow-up sonogram at 20 months shows a small low echoic scar (arrowheads).

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    Fig 2.

    Patient 3. BTT of the right thyroid gland in a 60-year-old man. A, A mixed cystic and solid tumor is treated with RFA twice. After the second RFA, the tumor is smaller at 1-week sonography (not shown). B and C, At 25 days, sonogram (B) and precontrast CT (C) show volume expansion and new hyperechoic and high-attenuation portions (arrows) representing intranodular bleeding. He had sudden swelling and pain on the right side of his neck 1 month after the second RFA. D and E, Tumor rupture is diagnosed by sonogram (D, arrows) and a postcontrast CT (E, arrows). F, The patient was managed with IV antibiotics, and the lesion gradually regressed (arrow).

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    Fig 3.

    Patient 5. A BTT of the right thyroid gland in a 36-year-old man. A, A 6.4-cm spongiform tumor is successfully treated with RFA. The 1-month follow-up sonogram after RFA shows a decrease in the tumor volume (54.9 to 34.2 mL). When he had abrupt neck pain and swelling 2 months after RFA, sonographically guided aspiration was performed. A small 2-mL semisolid blood clot was aspirated. Skin redness and pain developed, despite the patient taking oral antibiotics. B, Sonogram shows an aspiration tract from the needle (short arrows) and the rupture site (long arrows). C, Postcontrast CT scan shows a developed abscess and the ruptured tumor (arrows) into the right anterior neck. A right lobectomy was ultimately performed.

Tables

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  • Clinical and imaging findings and management in 6 patients with tumor rupture after RFA

    No.SexAge (yr)Initial Tumor SiteSize (mm)No. of RFAsRF AT (min)/Max Power (W)Rupture from Last RFA (day)Aspiration after RuptureInitial TreatmentFinal Treatment, Follow-UpSonographic Mass Composition
    1M28Left anterior23 × 37 × 46225/80 (1st)/20/80 (2nd)50NoObservationObservationMixed echoic, >50% cystic
    2F29Left anterior11 × 16 × 23320/70 (1st)/14/80 (2nd)/6/50 (3rd)60NoObservationObservationMixed echoic, >50% cystic
    3M60Right anterior24 × 23 × 35220/70 (1st)/21/90 (2nd)30YesIV antibioticsIV antibioticsMixed echoic, >50% solid
    4M53Left anterior51 × 29 × 50140/8022YesNo treatmentIncision and drainageMixed echoic, >50% cystic
    5M36Right anterior49 × 35 × 64135/13060YesOral antibioticsUnilateral lobectomyMixed echoic, spongiform
    6F52Left anterior25 × 15 × 32222/80 (1st)/20/100 (2nd)9NoIV antibioticsIncision and drainageSolid
    • Note:—Max indicates maximum.

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American Journal of Neuroradiology: 32 (11)
American Journal of Neuroradiology
Vol. 32, Issue 11
1 Dec 2011
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Cite this article
J.H. Shin, S.L. Jung, J.H. Baek, J.-h. Kim
Rupture of Benign Thyroid Tumors after Radio-Frequency Ablation
American Journal of Neuroradiology Dec 2011, 32 (11) 2165-2169; DOI: 10.3174/ajnr.A2661

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Rupture of Benign Thyroid Tumors after Radio-Frequency Ablation
J.H. Shin, S.L. Jung, J.H. Baek, J.-h. Kim
American Journal of Neuroradiology Dec 2011, 32 (11) 2165-2169; DOI: 10.3174/ajnr.A2661
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