Percutaneous ethanol injection of large autonomous hyperfunctioning thyroid nodules.
OBJECTIVE
To verify the effectiveness of percutaneous ethanol injection (PEI) in the treatment of large (>30-mL) hyperfunctioning thyroid nodules.


METHODS
Twelve patients (eight women, four men; age range, 26-76 years) with a large hyperfunctioning thyroid nodule (volume range, 33-90 mL; mean, 46.08 mL) underwent PEI treatment under ultrasonographic (US) guidance. US was used to calculate the volume of the nodules and to assess the diffusion of the ethanol in the lesions during the procedure. When incomplete necrosis of the nodule was depicted at scintigraphy performed 3 months after treatment, additional PEI sessions were performed.


RESULTS
Four to 11 PEI sessions (mean, seven) were performed in each patient, with an injection of 3-14 mL of 99.8% ethanol per session (total amount of ethanol per patient, 30-108 mL; mean, 48.5 mL). At scintigraphy after treatment in all patients, recovery of extranodular uptake, absence of uptake in the nodule, and normalization of thyroid-stimulating hormone (thyrotropin) levels were observed. In all patients, US showed volume reductions of 30%-50% after 3 months and 40%-80% after 6-9 months. Side effects were self-limiting in all patients. During the 6-48-month follow-up, no recurrence was observed.


CONCLUSIONS
PEI is an effective and safe technique for the treatment of large hyperfunctioning thyroid nodules.
Tarantino
L
L
Ultrasound Service, D. Cotugno Hospital, Torre del Greco (Na), Italy.
Giorgio
A
A
Mariniello
N
N
de Stefano
G
G
Perrotta
A
A
Aloisio
V
V
Tamasi
S
S
Forestieri
M C
MC
Esposito
F
F
Esposito
F
F
Finizia
L
L
Voza
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006980:Hyperthyroidism / Q000175:diagnosis / Q000188:drug therapy*; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D019233:Retreatment; D013670:Sodium Pertechnetate Tc 99m; D016606:Thyroid Nodule / Q000175:diagnosis / Q000188:drug therapy*; D014463:Ultrasonography
D000431:Ethanol; D013670:Sodium Pertechnetate Tc 99m