Benign thyroid nodule rupture after thermal ablation: a retrospective study and literature review

Nodule rupture is a complication following the thermal ablation of benign thyroid nodules. This study aimed to summarize the risk factors, clinical manifestations, diagnosis, and treatment of this complication through a retrospective study and literature review. From September 2021 to August 2023, 362 patients with benign thyroid nodules underwent thermal ablation at our institution. Nodule rupture occurred in 7 of these patients. Data regarding demographics, medical history, and auxiliary examinations were collected. Statistical analyses were conducted using group comparisons and logistic regression. All rupture cases occurred following microwave ablation, with incidence rates of 1.93% per patient and 1.68% per nodule. Multivariate logistic regression analysis identified the number of puncture points applied in a multi-point parallel overlapping mode (OR = 1.686; 95% CI: 1.032–2.818; p = 0.036) and higher energy output (OR = 1.648; 95% CI: 1.050–2.706; p = 0.032) as independent risk factors, and longer ablation duration as an independent protective factor (OR = 0.763; 95% CI: 0.580–0.969; p = 0.035). Significant intergroup differences were observed in anesthesia mode, nodule volume, operation duration, ablation duration, number of puncture points, and total energy output (all p < 0.05). The number of puncture points and total energy output are positively associated with the risk of nodule rupture. The common clinical manifestations include neck swelling and pain. This complication typically presents a self-limiting course with a favorable prognosis. Therapeutic strategies include early conservative treatment (observation or symptomatic therapy) and invasive treatment (catheter drainage or surgery). Not applicable.