Article Figures & Data
Figures
- 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).
- 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).
- 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
Clinical and imaging findings and management in 6 patients with tumor rupture after RFA
No. Sex Age (yr) Initial Tumor Site Size (mm) No. of RFAs RF AT (min)/Max Power (W) Rupture from Last RFA (day) Aspiration after Rupture Initial Treatment Final Treatment, Follow-Up Sonographic Mass Composition 1 M 28 Left anterior 23 × 37 × 46 2 25/80 (1st)/20/80 (2nd) 50 No Observation Observation Mixed echoic, >50% cystic 2 F 29 Left anterior 11 × 16 × 23 3 20/70 (1st)/14/80 (2nd)/6/50 (3rd) 60 No Observation Observation Mixed echoic, >50% cystic 3 M 60 Right anterior 24 × 23 × 35 2 20/70 (1st)/21/90 (2nd) 30 Yes IV antibiotics IV antibiotics Mixed echoic, >50% solid 4 M 53 Left anterior 51 × 29 × 50 1 40/80 22 Yes No treatment Incision and drainage Mixed echoic, >50% cystic 5 M 36 Right anterior 49 × 35 × 64 1 35/130 60 Yes Oral antibiotics Unilateral lobectomy Mixed echoic, spongiform 6 F 52 Left anterior 25 × 15 × 32 2 22/80 (1st)/20/100 (2nd) 9 No IV antibiotics Incision and drainage Solid -
Note:—Max indicates maximum.
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