Plummer’s disease: localized thyroid autonomy

Wiener, Jan D.

doi:10.1007/bf03347193

Cited by 29 publications

(24 citation statements)

References 107 publications

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“…The standard strategies for treatment of AFTN are surgical removal or radioactive iodine ablation [5,6]. However, surgery often has serious peri-or postoperative complications, and radioactive iodine ablation requires special equipment.…”

Section: Discussionmentioning

confidence: 99%

“…In benign thyroid complex cyst, thyroid hormone suppressive therapy is known to have little effect, and therefore surgical excision is usually chosen when the cyst compresses adjacent structures or causes cosmetic problems [2][3][4]. The mainstay treatment for autonomously functioning thyroid nodule (AFTN) is radioactive iodine ablation or surgery [5,6]. However, radioactive iodine ablation requires special equipment and surgery is often complicated.…”

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confidence: 99%

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Effectiveness of Percutaneous Ethanol Injection Therapy in Benign Nodular and Cystic Thyroid Diseases: Long-term Follow-up Experience

Lee

Ahn

2005

Endocr J

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Abstract. This study was designed to clarify the long-term efficacy and safety of percutaneous ethanol injection (PEI) therapy in benign nodular and cystic thyroid diseases, and to evaluate response by criteria defined as disappearance of hot nodule. Solid nodule and complex cyst were classified into three groups in accordance with volume reduction. In autonomously functioning thyroid nodule (AFTN), disappearance of hot nodule with normalization of thyroid hormone level and restored extra-nodular uptake was defined to be curative. In solid nodule (n = 198) and complex cyst (n = 432), initial volume was significantly reduced to post-PEI and final volumes, and volume reduction persisted during follow-up period. Complete response, partial response and no response were as follows: 17.2%, 71.7%, 11.1% in solid nodule; 19.0%, 60.4%, 20.6% in complex cyst, respectively. Differences of volume reduction according to initial volume (³10 mL vs. <10 mL) were significant. Correlations between initial and final volumes, and between initial volume and volume reduction were also significant. In 24 patients with AFTN, when effectiveness was assessed by disappearance of hot nodule, only 1 case was curative. Reexpansion or recurrence was observed in 5 cases. Complications developed in 9.0% but there was no permanent or serious complication in this study. In conclusion, our data suggest that PEI therapy could be an effective and safe therapeutic modality for benign nodular and cystic thyroid diseases especially when initial volume is more than 10 mL, but may not induce disappearance of hot nodule itself in AFTN.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Effectiveness of Percutaneous Ethanol Injection Therapy in Benign Nodular and Cystic Thyroid Diseases: Long-term Follow-up Experience

Lee

Ahn

2005

Endocr J

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“…The established treatments for hyperfunctioning thyroid nodule are surgical excision and radioiodine (Hamburger, 1987;Wiener, 1987). PEI therapy has been proposed as a suitable alternative by preliminary reports with short-term follow-up (Goletti et al, 1990;Livraghi et al, 1990;Monzani et al, 1991;Martino et al, 1992;Paracchi et al, 1992;Papini et al, 1993).…”

Section: Discussionmentioning

confidence: 99%

Five‐year follow‐up of percutaneous ethanol injection for the treatment of hyperfunctioning thyroid nodules: a study of 117 patients

Monzani¹,

Caraccio²,

Goletti

et al. 1997

Clinical Endocrinology

108

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Our data confirm the efficacy and safety of percutaneous ethanol injection for the therapy of autonomous thyroid nodules. The very low incidence of hypothyroidism along with the absence of recurrence of hyperthyroidism suggests that percutaneous ethanol injection is the treatment of choice in patients with pretoxic thyroid adenoma. Percutaneous ethanol injection appears an effective alternative procedure in toxic patients with a high surgical risk even if they have large nodules, and in younger ones in whom radioiodine is contraindicated. Patients may be submitted to anti-thyroid drug and/or beta-blocker therapy if it is necessary, but this does not affect percutaneous ethanol injection treatment outcome. Finally, not only single autonomous thyroid nodules but also toxic multinodular goitre may be successfully treated by percutaneous ethanol injection.

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“…Although some authors' included non-toxic AFTN where extranodular tissue was not suppressed, the incidence of permanent hypothyroidism following 131J therapy was relatively higher than that following surgery. ','•',", 1 Huysmans et al" insisted that 13 'I therapy had to be postponed when pretreatment scintigraphy revealed radioiodine uptake in extranodular parenchyma. Enucleation or lobectomy is a standard surgical procedure for AFTN.…”

Section: Discussionmentioning

confidence: 99%

“…3 Most of the patients with AFTN are euthyroid at diagnosis and remain so, but if once hyperthyroidism occurs, antithyroid drugs (ATD) are only palliative. [1][2][3] Conventional therapy has been surgery or radioiodine, I both of which have drawbacks or side effects. There were reports recently that percutaneous ethanol injection therapy (PEIT) could be an alternative to those therapies.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous ethanol injection therapy for autonomously functioning thyroid nodule

et al. 1996

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Four patients with solitary autonomously functioning thyroid nodule (AFTN; 2 toxic and 2 subclinically toxic) received ultrasonography (US)-guided percutaneous ethanol injection therapy (PEIT). The pretreatment scintigraphic appearance of the nodule was hot, and radioactivity in the extranodular tissue was completely suppressed throughout. Ninety-nine percent ethanol was slowly injected under US guidance. As a rule, the injection was performed in fractionated sessions and the treatment was repeated until the total amount of ethanol exceeded the baseline nodular volume. The therapy was successful. Complete remission of hyperthyroidism was observed among the patients with toxic nodule. The basal level of TSH and its response to TRH injection was normalized in the patients with subclinically toxic nodule. Posttreatment scintigrams revealed that the extranodular tissue recovered and radioactivity in the hot nodule had noticeably decreased. The rate of reduction in the nodular volume was more than 80% in all. There was no recurrence or development of hypothyroidism during a follow up of 10 to 23 months. The main side effect was mild and transient pain and/or a burning sensation at injection. No severe or permanent complications occurred. Although the number of our cases was small, the results suggest that PEIT is a useful program in treating AFTN.

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Plummer’s disease: localized thyroid autonomy

Cited by 29 publications

References 107 publications

Effectiveness of Percutaneous Ethanol Injection Therapy in Benign Nodular and Cystic Thyroid Diseases: Long-term Follow-up Experience

Effectiveness of Percutaneous Ethanol Injection Therapy in Benign Nodular and Cystic Thyroid Diseases: Long-term Follow-up Experience

Five‐year follow‐up of percutaneous ethanol injection for the treatment of hyperfunctioning thyroid nodules: a study of 117 patients

Percutaneous ethanol injection therapy for autonomously functioning thyroid nodule

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