Radiofrequency ablation for difficult thyroid nodule resulting complete resolution after following 6 months: a case report

Background: Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer and carries the best overall prognosis, which usually managed with total thyroidectomy as recommended by the current guidelines. Following subtotal thyroidectomy, patients may experience residual or recurrent disease which can be managed through operative surgery, radio-iodine therapy, and, more recently, radiofrequency ablation (RFA). This case illustrates the management of difficult thyroid nodule following subtotal thyroidectomy for PTC, and the role and potential benefits of RFA as a minimally invasive treatment option. Case Description: A 45-year-old female diagnosed with PTC in October 2022 underwent subtotal thyroidectomy and received suboptimal treatment at a peripheral hospital, presented with residual thyroid tissue and the nodule were detected 6 months later with elevated thyroglobulin level. Despite the completion of thyroidectomy, it remained. The patient underwent RFA and followed for 6 months, where there was complete resolution of the nodule without complications based on ultrasound, thyroglobulin and our clinical judgment since there was no clear guideline. Conclusions: RFA is a safe, useful, valuable, minimally invasive procedure, especially for small residual thyroid nodules post-thyroidectomy. Further research and trials are needed to establish the applicability and long-term effectiveness of the RFA.