Percutaneous ethanol injection therapy for autonomously functioning thyroid nodule

Nakada, Kunihiro; Katoh, Chietsugu; Kanegae, Kakuko; Tsukamoto, Eriko; Itoh, Kazuyoshi; Tamaki, Nagara

doi:10.1007/bf03165389

Cited by 10 publications

(7 citation statements)

References 14 publications

(5 reference statements)

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“…Long‐term outcomes suggested that around 80% of patients could be completely cured, 16% had a partial response, and 4% did not respond . Similar outcomes have been reported by a wide range of groups over the following 25 years . Although this technique has performed well, outcomes seem better in pre‐toxic than clinically toxic nodules and smaller nodules respond more reliably than larger ones .…”

Section: Benign Thyroid Nodulessupporting

confidence: 63%

Image‐guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications

et al. 2018

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Image-guided ablation of thyroid disease is increasingly being commonly reported. Techniques including ethanol injection and thermal ablation using radio-frequency, laser, and microwave devices have been described. Minimally invasive approaches to the management of benign cystic, solid, and functional thyroid nodules as well as both primary and recurrent thyroid malignancy have been reported. The purpose of this article is to review the current evidence relating to image-guided ablation of thyroid disease with a focus on clinical outcomes and complication rates for patients treated with this minimally invasive approach.

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Section: Benign Thyroid Nodulessupporting

confidence: 63%

Image‐guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications

et al. 2018

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“…The results of several studies on PEI, performed especially in Europe (9, 13, 16, 18–20), but also elsewhere (15), corroborated the simplicity, safety and efficacy of this method in the treatment of localized lesions of the thyroid gland. However, the histopathology of the thyroid following PEI therapy is not well documented.…”

mentioning

confidence: 66%

“…Percutaneous ethanol injection (PEI) was first used in the treatment of thyroid cysts in 1987 (13), and subsequently, due to the satisfactory early results obtained, it was proposed for the treatment of solid thyroid nodules, both toxic (8,14,15) and non-toxic (9,(16)(17)(18).…”

mentioning

confidence: 99%

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

Pomorski

Bartos

2002

APMIS

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This paper reports macro- and microscopic changes in hyperfunctioning thyroid nodules (HTN), initially diagnosed as solitary, in patients treated with percutaneous ethanol injection (PEI). In 78 patients, benign solitary HTN were diagnosed by clinical and hormonal examination. High resolution ultrasonography confirmed the solitary nodule. The results of fine needle aspiration biopsy (FNAB), performed twice, ruled out malignancy of the nodule. The patients were referred for PEI treatment. At 1-year follow-up, newly formed thyroid nodules, whose volumes increased, were detected in five patients (6.4%) with HTN, initially diagnosed as solitary. Therefore, these patients were operated on. Subtotal thyroidectomy was performed. At the intraoperative macroscopic evaluation, a hard fibrous solid mass was found in place of three nodules (n1, n2, n3) following PEI treatment. The middle area of the cut surface of PEI-treated nodules (n4 and n5) in the other two patients was firm and haemorrhagic, surrounded by a fibrous mass. Histolopathologic examination of n1, n2 and n3 revealed fibrosis and hyalinosis. Examination of n4 and n5 showed haemorrhagic necrosis in the middle of the nodules surrounded by fibrous tissue.

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“…Other treatment. Reluctance to use radioactive tracers has been the incentive for numerous Italian centers to introduce percutaneous ethanol injection therapy (PEIT) during the last 12 yr, but none has compared PEIT with standard therapy ( 131 I or surgery), and the studies comprise only selected patients (292)(293)(294)(295)(296)(297)(298)(299)(300)(301)(302)(303)(304)(305)(306)(307)(308)(309)(310)(311). The sclerosing properties of ethanol have been recognized for many years, and the mechanism of action is a coagulative necrosis and concomitant small vessel thrombosis.…”

Section: Solitary Hot Nodulementioning

confidence: 99%

Management of Simple Nodular Goiter: Current Status and Future Perspectives

2003

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The simple nodular goiter, the etiology of which is multifactorial, encompasses the spectrum from the incidental asymptomatic small solitary nodule to the large intrathoracic goiter, causing pressure symptoms as well as cosmetic complaints. Its management is still the cause of considerable controversy. The mainstay in the diagnostic evaluation is related to functional and morphological characterization with serum TSH and (some kind of) imaging. Because malignancy is just as common in patients with a multinodular goiter as patients with a solitary nodule, we support the increasing use of fine-needle aspiration biopsy (cytology). Most patients need no treatment after malignancy is ruled out. In case of cosmetic or pressure symptoms, the choice in multinodular goiter stands between surgery, which is still the first choice, and radioiodine if uptake is adequate. In addition to surgery, the solitary nodule, whether hot or cold, can be treated with percutaneous ethanol injection therapy. If hot, radioiodine is the therapy of choice. Randomized studies are scarce, and the side effects of nonsurgical therapy are coming into focus. Therefore, the use of the optimum option in the individual patient cannot at present be based on evidence. However, we are of the view that levothyroxine, although widely used, should no longer be recommended routinely for this condition. Within a few years, the introduction of recombinant human TSH and laser therapy may profoundly alter the nonsurgical treatment of simple nodular goiter.

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Percutaneous ethanol injection therapy for autonomously functioning thyroid nodule

Cited by 10 publications

References 14 publications

Image‐guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications

Image‐guided chemical and thermal ablations for thyroid disease: Review of efficacy and complications

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

Management of Simple Nodular Goiter: Current Status and Future Perspectives

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