Radio Frequency Ablation of Enlarged Thyroid Nodules: A Case Report

In the thyroid, abnormal growth can be the result of either benign thyroid nodules (BTNs) or differentiated thyroid cancers (DTCs). If the growth is confirmed to be a DTC, surgical intervention, either a partial or total thyroidectomy, is recommended. Although a majority of BTNs do not require treatment, intervention becomes necessary when nodules cause symptoms, enlargement, or a rare suspicion of malignancy. Clinical presentations of symptoms include psychological and aesthetic ones, such as a large lump on the neck, difficulty swallowing, pressure on the neck, and/or voice changes. The most common form of intervention for minimizing the volume of the BTN is surgery. However, due to several drawbacks to surgery and patient ineligibility, minimally invasive techniques such as radiofrequency ablation (RFA) have been recommended. Radiofrequency ablation serves as a minimally invasive non-surgical procedure that has been recognized to decrease the volume of BTNs.  In the following case, we present a 50-year-old female patient with a growing multinodular goiter (MNG). A thyroid fine needle aspiration (FNA) biopsy and genetic testing confirmed the diagnosis of thyroid disease with possible malignancies. The nodule was increasing in size, causing discomfort, and possible malignancies were indicated by the FNA results. In order to avoid surgical intervention, the patient chose to undergo RFA, effectively decreasing the size of the BTN and dissipating the symptoms. This case highlights the effectiveness of RFA as a non-surgical alternative for treating benign MNG. Additionally, this case study provides insight into the unique treatment plans available for patients who opt out of surgery.