Ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinoma

Abstract

Background: Severe hypercalcemia is the leading cause of death in patients with parathyroid carcinoma. Non-curative resection and pharmacological measures may be useful for palliation in cases with recurrent and metastatic disease. Palliative treatment with intra-neoplastic ethanol injection has not been reported yet. Methods: Ultrasound-guided percutaneous alcohol injection in one patient with unresectable parathyroid carcinoma is reported. Results: One male patient with extensive recurrent parathyroid carcinoma suffering from severe hypercalcemia, refractory to all available medical measures has undergone two percutaneous ethanol injections. No major complications ensued and parathormone levels decreased from 2,990 pg/mL to 2,230pg/ml after the first injection, and to 1,104pg/mL after the second one. Calcium levels decreased from 19.8 mg/dL to 16.1 mg/dL and to 14.5 mg/dL, respectively. The patient died of metabolic hypercalcemia complications about two months later, probably due to mediastinal disease progression. Conclusion: Ultrasound-guided percutaneous ethanol injection may be employed to palliate parathyroid carcinoma in selected cases, with a transitory decrease in PTH and calcium levels. Arq Bras Endocrinol Metab 2008; 52/4:707-711)

Outcomes for dogs with primary hyperparathyroidism following treatment with percutaneous ultrasound-guided ethanol ablation of presumed functional parathyroid nodules: 27 cases (2008–2011)

“…6,9,12 In 1 study 6 comparing complication rates of surgical parathyroidectomy, heat ablation, and ethanol ablation in dogs, no significant difference among complication rates was found. 14 The purpose of the study reported here was to describe outcomes for dogs with primary hyperparathyroidism following treatment with percutaneous ultrasound-guided ethanol ablation of presumed functional parathyroid nodules. 6,9 Humans undergoing ethanol ablation procedures describe a transient, tolerable pain at the injection site.…”

Parathyroid carcinoma. The experience of treatment of 15 patients and a review

“…При невозможности хирургического лечения могут применяться методы локального воздействия, в том числе радиочастотная абляция метастатических очагов в легких и печени, а также трансартериальная эмболизация [11][12][13]. Сообщалось об успешной склеротерапии местных рецидивов 96 % этанолом [25], однако высокая частота повреждения этанолом возвратного гортанного нерва не позволяет широко использовать данную Опухоли ГОЛОВЫ и ШЕИ HEAD and NECK tumors Том 10 Vol. 10 3'2020 Диагностика и лечение опухолей головы и шеи методику при очагах на шее [26].…”

Current and Future Treatments for Parathyroid Carcinoma

“…Given the development of jaw tumors, a dental panorex image every 5 years is also recommended [49]. In patients with diagnosed PC, lifelong surveillance is recommended [50,51].…”

“…True efficacy of this treatment remains unknown, however, as only anecdotal case reports exist. Likewise, isolated reports of ethanol ablation temporarily decreasing serum calcium and PTH levels suggest use of ultrasound-guided injection for palliation of PC in selected cases [50]. This modality, however, should be reserved for disease outside of the central neck, as ethanol injection in the central neck can permanently injure a functioning recurrent laryngeal nerve.…”