Known thyroid nodule since 2014, now with symptoms of choking, difficulty swallowing, and foreign body sensation (something stuck in her throat). Severe anxiety at night when trying to sleep because of difficulty breathing. Her US report measure her left thyroid lobe nodule as 5.5 x 3.9 x 5.1 cm two years prior to her current evaluation. Her thyroid function is normal. TSH 0.65, Free T4 1.3. All biopsies have been benign. Her current ultrasound demonstrates a 79 ml nodule (6.2 x 4.2 x 5.9 cm) which has a prominent internal cystic component. She elected to undergo US guided cyst decompression to temporarily reduce the size of the nodule. Over the next few weeks, she experienced significant relief, so then elected to undergo a repeat US guided cyst aspiration, immediately followed with US guided RFA of her prominent left thyroid nodule.