Alcoolização de nódulo tiroidiano em região endêmica de bócio colóide

Abstract

RESUMOA doença nodular tiroidiana é problema clínico comum, principalmente em regiões com carência de iodo. Esse estudo avaliou a eficácia da injeção percutânea de etanol (IPE) no tratamento de nódulos tiroidianos únicos, múltiplos, sólidos, císticos, de diferentes tamanhos com ou sem disfunção glandular, em região endêmica de bócio. Quarenta e dois pacientes com diagnóstico de bócio colóide ou hiperplasia nodular colóide, na punção biópsia aspirativa por agulha fina (PBAAF), foram selecionados para análise após terem sido submetidos a pelo menos duas IPEs. Os nódulos tiroidianos eram múltiplos (sólidos e ou císticos) em 52,4% dos pacientes, únicos e sólidos ou mistos em 35,7% e únicos e císticos em 11,9%. A redução média dos nódulos após injeção de etanol foi de 58,2% para os únicos e 60,8% nos císticos. ABSTRACT Alcoholization in the Treatment of Thyroid Nodule in Colloid Goiter Endemic Region.Thyroid nodular disease is a common clinical disorder mainly in iodine lacking regions. This study has evaluated the effectiveness of percutaneous ethanol injection (PEI) in the treatment of single, multiple, solid, and cystic thyroid nodules of different sizes with or without glandular dysfunction, in goiter endemic region. Forty-two patients with diagnosis of colloid goiter or colloid nodular hyperplasia in fine-needle aspiration (FNA) were selected for analysis, after having been submitted to at least two PEI. Thyroid nodules were multiple (solid and or cystic) in 52.4% of the patients, single and solid or mixed in 35.7%, and single and cystic in 11.9%. The mean reduction of nodules after ethanol injection was of 58.2% in the single and of 60.8% in the cystic ones. The reduction of the whole thyroid lobe was evaluated in the multiple nodules and it reached 52.4%. The sideeffects were registered only as a consequence of the application discomfort. This study points out that the percutaneous ethanol injection reaching volume mean reductions, varying from 49% to 60%, is a safe, effective, and simple method for the treatment of benign thyroid nodules.

Ultrasound-Guided Percutaneous Ethanol Injection Protocol to Treat Solid and Mixed Thyroid Nodules

“…This method has been suggested to be an effective, safe, and inexpensive outpatient procedure for the treatment of benign TNs, leading to reduction of nodular volume, with a low rate of early and late clinical complications ( 3 , 17 – 29 ). It has been recommended as the first-line therapy of symptomatic and recurrent thyroid cysts with benign cytology ( 30 ), and may also be used in solid nodules, particularly in case of contraindication to or refusal of surgery and radioiodine therapy ( 2 , 31 – 34 ).…”

Evaluation of percutaneous ethanol injections in benign thyroid nodules

“…PEI is a safe procedure without serious complications, and immediate pain is the most common complication. Other complications can occur and are described in the literature as unilateral vocal paralysis (0.7%) (23), hematoma at the injection site (0.2-23%) (4,23), dysphonia (2.6-4.7%) (4,24), transitory hypotension (0.2%) (23), transitory thyrotoxicosis (3.2%) (8), and fibrosis complicating subsequent surgery (1.6%) (8). The main limitation of this study is the retrospective evaluation of data.…”