Histologic changes in thyroid nodules after percutaneous ethanol injection in patients subsequently operated on due to new focal thyroid lesions

Pomorski, Lech; Bartos, M

doi:10.1034/j.1600-0463.2002.100208.x

Cited by 24 publications

(19 citation statements)

References 21 publications

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“…In 1990, PEI was shown to improve hyperthyroidism and reduce the size of hyperfunctioning nodules (8). Intranodular injec tion of ethanol leads to a complex and irreversible local injury associated with hemorrhagic infarction, throm bus formation, coagulative necrosis and fibrosis sparing areas outside the nodule (9). Therefore, PEI has been an increasingly common therapeutic alternative for thy roid nodules, with positive results confirmed by several groups within the last decade (1014).…”

Section: Introductionmentioning

confidence: 86%

“…How ever, with the IPE technique guided by US, only the nodule suffers action of ethanol, sparing the surround ing tissue, also explaining the low rate of early and late complications (23). Other authors also evaluated macroscopically and microscopically glandular ethanol changes, which claim that the therapy does not affect the extranodular tissue (9). Therefore, treatment with IPE does not preclude the subsequent surgical treat ment, which may be performed safely (10).…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous ethanol injection versus conservative treatment for benign cystic and mixed thyroid nodules

Ferreira

Piaia²,

Cadore³

2016

Arch. Endocrinol. Metab.

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Objective: To evaluate the efficacy and safety of percutaneous ethanol injection (PEI) in reducing the volume of cystic and mixed thyroid nodules. Materials and methods: A total of 36 patients with nodules treated with PEI and 13 individuals who declined PEI and were followed clinically or received other non surgical treatment (control group). Assessments were performed at baseline (immediately before treatment in the PEI group or evaluation of the nodule on ultrasonography in the control group) at short-term (on average 30 days after the last injection in the PEI group), and long-term (on average 14 months after baseline in the PEI group or 26 months after baseline in the control group). Results: In the PEI group, the mean baseline volume of 10.4 ± 9.8 cm³ reduced at short-term followup to 2.9 ± 3.1 cm³ (67.7 ± 19.9%, p < 0.001) and at long-term follow-up to 2.0 ± 2.5 cm³ (78.2 ± 19.5%, p < 0.01 versus baseline and p = 0.009 versus short-term follow-up). Both types of nodules showed similar degrees of reduction. In the control group, mean volume was 5.8 ± 3.4 cm³ at baseline and 6.2 ± 3.0 cm³ at long-term follow-up (p = 0.507). Compared with the control group, the PEI group showed larger reduction (p < 0.001). Conclusions: PEI is effective in reducing the volume of cystic and mixed benign thyroid nodules, with sustained long-term efficacy and better outcome when compared with conservative therapies. Treatment with PEI is a safe alternative, with minimal, transient and selflimited adverse events. Arch Endocrinol Metab. 2016;60(3):211-6

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Section: Introductionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Percutaneous ethanol injection versus conservative treatment for benign cystic and mixed thyroid nodules

Ferreira

Piaia²,

Cadore³

2016

Arch. Endocrinol. Metab.

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“…The histopathological findings of hyaline thickness of blood vessels after exposure to radioactivity correspond to changes described after therapy of thyroid hyperfunction by injection of ethanol through the skin (19). The balance between thyroid regeneration and fibrosis appears to determine in part whether hypothyroidism will occur (1).…”

Section: Discussionmentioning

confidence: 99%

131I-induced changes in rat thyroid gland function

Torlak¹,

Zemunik²,

Modun³

et al. 2007

Braz J Med Biol Res

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Therapeutic doses of 131 I administered to thyrotoxic patients may cause thyroid failure. The present study used a rat model to determine thyroid function after the administration of different doses of 131 I (64-277 µCi). Thirty male Fisher rats in the experimental group and 30 in the control group (untreated) were followed for 6 months. The animals were 4 months old at the beginning of the experiment and were sacrificed at an age of 9 months. Hormone concentration was determined before 131 I administration (4-month-old animals) and three times following 131 I administration, when the animals were 7, 8, and 9 months old. The thyroid glands were removed and weighed, their volume was determined and histopathological examination was performed at the end of the experiment. Significant differences in serum triiodothyronine and thyroid-stimulating hormone concentration, measured at the age of 7, 8, and 9 months, were found in the experimental group. During aging of the animals, the concentration of thyroxin fell from 64.8 ± 8.16 to 55.0 ± 6.1 nM in the control group and from 69.4 ± 6.9 to 25.4 ± 3.2 nM in the experimental group. Thyroid gland volume and weight were significantly lower in the experimental than in the control group. Thyroid glands from the experimental group showed hyaline thickness of the blood vessel wall, necrotic follicles, a strong inflammatory reaction, and peeling of necrotic cells in the follicles. In conclusion, significant differences in hormone levels and histopathological findings indicated prolonged hypothyroidism after 131 I administration to rats, which was not 131 I dose dependent. Correspondence

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“…Levando em consideração as alterações ocasionadas pelo etanol no tecido tiroidiano como fibrose, necrose hemorrágica e inflamação (18), e que tais processos têm um período mínimo para se resolverem, é compreensível a diminuição contínua do volume dos nódulos observada até seis meses após uma aplicação. Dessa maneira, a realização das injeções com intervalos médios de seis meses, como demonstrado nesse trabalho, parece ser o mais adequado.…”

Section: Discussionunclassified

Alcoolização de nódulo tiroidiano em região endêmica de bócio colóide

Lima¹,

Fagundes

Raffaelli³

et al. 2007

Arq Bras Endocrinol Metab

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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.

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Histologic changes in thyroid nodules after percutaneous ethanol injection in patients subsequently operated on due to new focal thyroid lesions

Cited by 24 publications

References 21 publications

Percutaneous ethanol injection versus conservative treatment for benign cystic and mixed thyroid nodules

Percutaneous ethanol injection versus conservative treatment for benign cystic and mixed thyroid nodules

131I-induced changes in rat thyroid gland function

Alcoolização de nódulo tiroidiano em região endêmica de bócio colóide

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