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Percutaneous Ethanol Injection (PEI) for Thyroid Cysts and Other Neck Lesions

  • Andrea FrasoldatiEmail author
  • Petros Tsamatropoulos
  • Daniel S. Duick
Chapter

Abstract

Percutaneous ethanol injection (PEI), also known as ethanol, or alcohol, ablation, is the first-line treatment for thyroid cystic nodules. Immediately after its instillation into the thyroid tissue, ethanol causes coagulative necrosis and fibrotic changes resulting in a stable and durable regression of the treated cystic lesion. Long-term effectiveness of PEI, along with its substantial safety, has been consistently documented by many studies published in the last decades: therefore this procedure has gained a worldwide diffusion. In parallel with the successful utilization of the sclerosing properties of ethanol in thyroid cystic nodules, PEI application for treatment of autonomously functioning thyroid nodules (AFTNs) or solid cold thyroid nodules has been progressively abandoned due to its poor efficacy, the not negligible risk of side effects, and the expanding use of other ultrasound-guided interventional techniques, namely, laser thermal ablation (LTA) and radio-frequency ablation (RFA). Ethanol ablation has also been used with good results for treating hyperplastic parathyroid (PT) glands in patients with chronic renal failure as well as large nonfunctioning PT cysts. In addition, in selected patients, metastatic lymph nodes from differentiated thyroid cancer can be treated with PEI as an alternative option to surgery.

Keywords

Percutaneous ethanol injection (PEI) Ethanol ablation (EA) Alcohol ablation Thyroid cyst Thyroid nodules Autonomously functioning thyroid nodules (AFTN) Parathyroid cyst Parathyroid adenoma Thyroid cancer Metastatic neck lymph nodes 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Andrea Frasoldati
    • 1
    Email author
  • Petros Tsamatropoulos
    • 2
  • Daniel S. Duick
    • 3
    • 4
  1. 1.Endocrinology Unit, Medical Specialities DepartmentArcispedale S. Maria Nuova – IRCCSReggio EmiliaItaly
  2. 2.Endocrinology UnitCentro PalmerReggio EmiliaItaly
  3. 3.University of Arizona College of MedicinePhoenixUSA
  4. 4.Endocrinology Associates, PAScottsdaleUSA

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