The occurrence of hyperthyroidism after thermal ablation for thyroid papillary carcinoma: a retrospective multicentre observational study

OBJECTIVE: In recent years, the incidence of papillary thyroid carcinoma (PTC) has been rapidly increasing, and thermal ablation techniques are gradually emerging as alternative therapies for PTC. The aim of this study was to comprehensively analyse potential factors leading to hyperthyroidism after thermal ablation treatment for PTC, providing a scientific reference for the prevention of and intervention for hyperthyroidism in such condition in the future. METHODS: Through the analysis of 22 papillary thyroid carcinoma (PTC) patients who received thermal ablation treatment in four different hospitals and later experienced hyperthyroidism during follow-up, we scrutinised their diagnostic and treatment procedures. This comprehensive analysis, in conjunction with pertinent data and reports, sought to delineate optimal approaches for both prevention and treatment. RESULTS: Among the PTC patients included in the study, 3 were males and 19 were females, with an average age of 36.05 ± 1.60 years. Thirteen patients underwent radiofrequency ablation treatment, while 9 patients received microwave ablation treatment. Before undergoing treatment, these 22 PTC patients presented no evident abnormalities in thyroid function and did not experience any hyperthyroidism-related symptoms. Additionally, within one week following thermal ablation treatment, thyroid function normalised. During the follow-up period, they subsequently developed hyperthyroidism, accompanied by decreased TSH, along with elevated FT3 and/or FT4. Some patients also presented with clinical symptoms of hyperthyroidism, such as heat intolerance, sweating, hand tremors, palpitations, and other associated signs. CONCLUSION: In summary, PTC patients who exhibit symptoms of thyroiditis or autoimmune diseases prior to the procedure may be at increased risk of developing hyperthyroidism following thermal ablation treatment.