Case Report #1

Toxic Thyroid Nodule Case Report

CASE:

35 yo WF with large thyroid nodule and borderline hyperthyroidism for 5 years. Within the last several months she developed recurrent heart palpitations and anxiety, difficulty sleeping, and muscle cramps. Methimazole was initiated to control symptoms. Her radioactive iodine uptake scan in 2017 demonstrated hot nodule on same side as her large thyroid nodule. She presented in November 2021 to the Thyroid Nodule Treatment Center for evaluation. TSH 0.01, Free T4 2.9. After medication provided temporary normalization of thyroid function, she elected to undergo RFA Thyroid Nodule of a 28.5 ml toxic (autonomous) nodule.

METHODS:

In December 2021 she underwent RFA of a 28.5 ml nodule using Joules of energy at the Thyroid Nodule Treatment Center.

RESULTS:

case 1 1mo post

1 month post

She states her symptoms have improved and she is off all medications. TSH , Nodule size reduced to 16.4 ml in size. 43% volume reduction.

3 months after ablation, the nodule is much less visible after 60% volume reduction

3 months post

She had dramatic decrease in size of her thyroid nodule by 56% (12.2 ml ) and has complete resolution of her symptoms. Her TSH is now Her endocrinologist has discharged her from his office because her thyroid functions have normalized.

Case#1-6mo-post

6 months post

She still has no symptoms of hyperthyroidism and she has dramatic decrease in the size of her thyroid nodule from 27 ml down to 9 ml, 68% volume reduction! She still requires no medications. TSH 2.71 Free T4 1.1

Case 1 1yr post

1 year post

: She continues to do exceptionally well. Her symptoms have not returned. 1 year post. Her large 28 ml nodule now measures 5.8 ml which is an 80% volume reduction.

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