[Treatment of parathyroid adenomas with ethanol injection under ultrasonographic guidance].
OBJECTIVE
The objective of this retrospective study was to report the results of ethanol injection in parathyroid adenomas.


METHODS
Since 1988, 31 patients with inoperable primary hyperthyroidism have been treated by ultrasound-guided percutaneous ethanol injection into the adenoma. The main surgical contraindications were heart failure (n = 12) and age over 85 years (n = 11). Plasma calcium and PTH were measured 48 hours after ethanol injection and during subsequent follow-up.


RESULTS
Patients had one to three ethanol injections. With a mean 5-year follow-up, total success with normal plasma calcium and PTH levels was achieved in 20 patients (64.5%), 4 of whom underwent another ethanol injection after 1 to 3 years. Partial success with correction of plasma calcium only was achieved in 9 patients (29%) resulting in an obvious clinical benefit. Failure was observed in 2 patients (6.5%) with nodular goiter, probably due to incorrect localization of the adenoma. Treatment was always well tolerated and no major side effect was observed.


CONCLUSIONS
Ultrasound-guided percutaneous ethanol injection of parathyroid adenoma is effective in most cases of hyperparathyroidism and very useful in patients with a high surgical risk. The need for precise ultrasound localization of the adenoma is the main limitation of this treatment.
Vergès
B
B
Service d'endocrinologie, diabétologie et maladies métaboliques, hôpital du Bocage, centre hospitalier universitaire de Dijon, France.
Cercueil
J P
JP
Jacob
D
D
Vaillant
G
G
Brun
J M
JM
D000236:Adenoma / Q000628:therapy*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012997:Solvents / Q000008:administration & dosage*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D012997:Solvents; D000431:Ethanol