Endocrine Abstracts

Radiofrequency ablation (RFA) is an emerging minimally invasive treatment for benign thyroid nodules, offering effective volume reduction with an acceptable safety profile. However, the rare complication of nodule rupture can occur in up to 2.5%. We report a case of thyroid nodule rupture complicated by infection following RFA, highlighting clinical presentation, diagnostic approach, management, and outcomes. A 34-year-old woman with a history of a euthyroid multinodular goitre presented with progressive painless neck swelling 2 months after a second RFA procedure. She had previously undergone uncomplicated initial RFA 12 months prior, with 50% nodule size reduction. Ultrasound imaging revealed a thyroid nodule rupture through the thyroid capsule and infection along the percutaneous tract. Over days, the swelling increased, later exhibiting erythema, tenderness, and fluid drainage. The patient was managed conservatively with antibiotics, local wound care, and close clinical and radiological monitoring. Over subsequent months, clinical and radiological improvements were observed, with the reduction of swelling size, resolution of the tract, and no further infectious signs. The patient (a co-author on this abstract) was highly involved in her own care, carefully cataloguing changes in her neck (photos, descriptions) in conjunction with other patients worldwide who had experienced this complication; this collaborative approach helped the clinicians in their management. Overall, there was a reduction in the size of her nodule from over 6 cm (prior to second RFA) to 3.3 cm (8 months following second RFA). Although RFA is generally safe, clinicians must remain conscious about rare but potentially serious complications such as nodule rupture and infection. Early recognition and tailoring of management strategies, ranging from conservative therapy to surgical intervention, are crucial. The patient’s favourable outcome with conservative management reinforces the role of close follow-up and shared decision-making.