case_images: PMC11019371_01
case_images: Baseline ultrasound demonstrates 4.2 cm solid homogenous, mildly hypoechoic nodule thyroid nodule replacing the majority of the left thyroid lobe in (A) longitude and (B) transverse views with (C) scant peripheral vascularity.
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case_images: Figure 1 ). Fine needle aspiration demonstrated benign cytology.
case_images: Photograph of patient neck at (A) 7 days post-RFA at time of initial complaint of transient redness and discomfort with spontaneous recovery and (B) at time of recurrent symptoms of pain, swelling, and redness at 1 month post-RFA prompting CT neck demonstrating findings of nodule rupture.
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case_images: One week post-RFA, the patient reported transient anterior neck discomfort associated with mild erythema for 24 h, which resolved without intervention ( Figure 2A ). At 4 weeks post-RFA, the patient reported mild, recurrent 3/10 anterior neck pain associated with redness and swelling ( Figure 2B ).
case_images: Ultrasound 7 days post-RFA with patient reported symptoms of transient erythema and fullness. Ultrasound without extrathyroidal mass but classic artifacts typical of immediate post-RFA including areas of (A) hyperechoic and hypoechoic changes with a non-distinct anterior border (B) without evidence of active bleeding.
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case_images: Ultrasound performed within 1 day of complaint demonstrated the continued presence of expected post-treatment changes including a non-distinct anterior border in close proximity to the treatment zone, however, with no evidence of extrathyroidal fluid extravasation ( Figure 3A ) or evidence of active bleeding ( Figure 3B ).
case_images: Four weeks post-RFA contrasted neck CT demonstrating a 3.3 cm x 2.1 cm x 3.5 cm (AP x TR x CC) low-density perithyroidal fluid collection with peripheral enhancement (arrow) deep to the sternocleidomastoid muscle with disruption of the anterior capsule (Asterix) associated with edema and reticulation of the overlying subcutaneous tissue and skin (arrowhead) consistent with nodule rupture. Features of the nodule rupture are shown in (A) transverse, (B) coronal, and (C) sagittal planes.
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case_images: Figure 4 ) consistent with thyroid nodule rupture. Findings were confirmed on subsequent ultrasonography ( Figure 5 ).
case_images: Serial ultrasound changes for 1 year following initial RFA procedure measured at time post-rupture, monitoring nodule rupture resolution.
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case_images: PMC11019371_01_fendo-15-1355383-g005.jpg
case_images: f5
case_images: Figure 4 ) consistent with thyroid nodule rupture. Findings were confirmed on subsequent ultrasonography ( Figure 5 ). Progress was monitored with ultrasound imaging over the course of 1 year following RFA ( Figure 5 ) demonstrating progressive resolution of rupture findings.