title: Treatment of large cold benign thyroid nodules not eligible for surgery with percutaneous ethanol injection.
abstract: We studied the effect of percutaneous ethanol injection (PEI) in the treatment of cold, cytologically benign, large (>10 mL) thyroid nodules (CBNs) in 41 patients. The end-point of our study was to evaluate the efficacy of PEI on: 1) local symptomatology, assessed by an arbitrary symptom score; and 2) nodule volume and tracheal displacement (at ultrasonography). Follow-up ranged from 12-36 (21 +/- 9) months. Symptom score was significantly reduced (P < 0.01) after 6 months and at the end of the follow-up (2.1 +/- 0.3 vs. 0.2 +/- 0.5 and vs. 0.2 +/- 0.4). A significant (P < 0.01) nodule volume reduction was observed, without differences between solid or mixed CBNs; the reduction was 50% or more in 92.7% of patients. Neither clinical parameters nor pretreatment nodule ultrasonographic features were related to nodule reduction. Disappearance or significant reduction (>0.5 cm) of tracheal displacement was obtained in 61% and in 39% of patients, respectively. One patient experienced prethyroid region edema, pain, and mild fewer, which reversed within 1 week; and one patient had dysphonia, caused by vocal cord palsy, which reversed spontaneously within 1 month. At the end of the follow-up, nodules with just necrotic material at cytology showed a greater (P < 0.05) volume reduction than nodules with residual benign thyroid cells. Our data suggest that PEI is a safe and effective treatment of large CBNs, although sometimes serious side effects do occur.
authors.affiliation: Division and Research Unit of Endocrinology, Scientific Institute, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Zingrillo
authors.forename: D
authors.initials: D
authors.lastname: Collura
authors.forename: M R
authors.initials: MR
authors.lastname: Ghiggi
authors.forename: V
authors.initials: V
authors.lastname: Nirchio
authors.forename: V
authors.initials: V
authors.lastname: Trischitta
mesh_terms: D000293:Adolescent; D000328:Adult; D017558:Elective Surgical Procedures; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D016606:Thyroid Nodule / Q000188:drug therapy*; D014132:Trachea / Q000000981:diagnostic imaging; D014463:Ultrasonography
chemical_list: D000431:Ethanol