Abstract
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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Winer JD. Plummer’s disease: localized thyroid autonomy.J Endocrinol Invest 10: 207–223, 1987.
McDougall IR.Thyroid Disease in Clinical Practice. London, UK, Chapman & Hall Medical, pp. 118–125, 1992.
Meier DA, Dworkin HJ. The autonomously functioning thyroid nodules.J Nucl Med 32: 27–30, 1991.
Bransom CJ, Talbot CH, Henry L, Elemenoglou J. Solitary toxic adenoma of the thyroid.Br J Surg 66: 590–595, 1979.
Eye-Brook IA, Talbot CH. The treatment of autonomous functioning thyroid nodules.Br J Surg 69: 577–579, 1982.
Thomas Jr CG, Croom RD. Current management of the patient with autonomously functioning nodular goiter.Surg Clin North Amer 67: 315–328, 1987.
Kinser LA, Rolesler H, Furrer T, Grutter D, Zimmermann H. Non immunogenic hypothyroidism incidence after radioiodine and surgical treatment.J Nucl Med 30: 1960–1965, 1989.
Goldstein T, Hart IR. Follow up of solitary autonomous thyroid nodules treated with131I.N Engl J Med 309: 1473–1476, 1983.
Ross DS, Ridgway EC, Daniels GH. Successful treatment of solitary toxic nodules with relatively low-dose iodine- 131, with low prevalence of hypothyroidism.Ann Intern Med 89: 85–90, 1984.
Berglund J, Christensen SB, Dymling JF, Hallengren B. The incidence of recurrence and hypothyroidism following treatment with antithyroid drug, surgery, or radioiodine in all patients with thyrotoxicosis in Malmo during the period 1970–1974.J Intern Med 229: 435–442, 1991.
Huysmans DA, Corstens FH, Kloppenborg PW. Long term follow-up in toxic solitary autonomous thyroid nodules treated with radioactive iodine.J Nucl Med 32: 27–30, 1991.
Livraghi T, Paracchi A, Ferrari C, Bergonzi M, Garavaglia G, Rainen P, et al. Treatment of autonomous thyroid nodules with percutaneous ethanol injection: preliminary results.Radiology 175: 827–829, 1990.
Monzani F, Goletti O, Caraccio N, Del Guerra P, Ferdeghini M, Pucci E, et al. Percutanous ethanol injection treatment of autonomous thyroid adenoma: hormonal and clinical evaluation.Clin Endocrinol 36: 491–497, 1992.
Mazzeo S, Toni MG, De Gaudio C, Caramella D, Pinto F, Lencioni R, et al. Percutaneous injection of ethanol to treat autonomous thyroid nodules.AJR 161: 871–876, 1993.
Paracchi A, Ferrari C, Livraghi T, Reschini E, Macchi RM, et al. Percutaneous intranodular ethanol injection: a new treatment for autonomous thyroid adenoma.J Endocrinol Invest 15: 353–362, 1992.
Martino E, Murtas ML, Loviselli A, Piga M, Petrini L, Miccoli P, et al. Percutanous intranodular ethanol injection for treatment of autonomously functioning thyroid nodules.Surgery 112: 1161–1165, 1992.
Di Lellio A, Rivolta M, Casati M, Capra M. Treatment of autonomous thyroid nodules. Value of percutaneous ethanol injection.AJR 164: 207–213, 1995.
Nakada K, Furudate M. Percutaneous ethanol injection therapy for unresectable recurrent thyroid carcinoma.Endocrine Surgery 12: 141–146, 1995.
Itoh K. Functional aspect of thyroid tumors.J Jpn Surg Soci 85: 1019–1022, 1984.
Hamburger JI. Evolution of toxity in solitary non toxic autonomously functioning nodules.J Clin Endocrinol Metab 50: 1089–1093, 1980.
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Nakada, K., Katoh, C., Kanegae, K. et al. Percutaneous ethanol injection therapy for autonomously functioning thyroid nodule. Ann Nucl Med 10, 171–176 (1996). https://doi.org/10.1007/BF03165389
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DOI: https://doi.org/10.1007/BF03165389