Treatment of recurrent nodular goiters with percutaneous ethanol injection: a clinical study of twelve patients.
Twelve patients who had previously undergone thyroid surgery received percutaneous ethanol injection (PEI) treatment because of recurrent nodular goiter (3 with a toxic [TN], 2 with a nontoxic cystic [NCN], and 7 with a nontoxic solid nodule [NSN]). Two of the 12 had recurrent nerve palsy contralateral to the nodule. Each patient received a mean total dose of 0.88 mL of ethanol per milliliter of nodular volume. Ethanol was injected in a mean of 3.5 sessions for solid and 3 sessions for NCN. In most cases, a slight to moderate burning pain was experienced during and for 12-48 hours after PEI treatment, and one patient experienced temporary hoarseness. One patient with TN and 2 patients with NSN became hypothyroid, 7 patients with nontoxic nodules remained euthyroid, 1 with TN became euthyroid, and a previously hyperthyroid patient with TN became subclinically hyperthyroid 1-year posttherapy. The nodule shrank by more than 50% of the pretreatment volume in all patients (8.6 +/- 2.6 vs. 2.9 +/- 1.2 mL in TN, and 12.3 +/- 4.9 vs. 4.16 +/- 2.54 mL in nontoxic nodules, pretreatment vs. 1 year posttreatment volume, respectively). With regard to the increased risk of reoperation, PEI treatment can be proposed for patients with recurrent nodular goiter requiring surgery.
Thyroid Outpatient Departments of Bugat Hospital (Gyöngyös), Erzsebet Hospital (Jaszbereny), St Lazar Hospital (Salgotarjan) and Matra State Hospital (Kekestetö), Hungary. mosolyis@axelero.hu
Tamas
T
Solymosi
Istvan
I
Gál
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006044:Goiter, Nodular / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D013963:Thyroid Hormones / Q000097:blood; D016606:Thyroid Nodule / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D016896:Treatment Outcome
D013963:Thyroid Hormones; D000431:Ethanol