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

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


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.


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 


  1. 1.
    Lubiensky A, Simon M, Helmberger TK. Percutaneous Alcohol Instillation In: Vogl TJ, Helmberger T, Mack MG, Reiser MF, editors. Percutaneous tumor ablation in medical radiology. Berlin Heidelberg: Springer-Verlag; 2008. p. 123–8.Google Scholar
  2. 2.
    Ahmed M, Solbiati L, Brace CL, Breen DJ, Callstrom MR, Charboneau JW, et al. International Working Group on Image-guided Tumor Ablation; Interventional Oncology Sans Frontières Expert Panel; Technology Assessment Committee of the Society of Interventional Radiology; Standard of Practice Committee of the Cardiovascular and Interventional Radiological Society of Europe. Image-guided tumor ablation: standardization of terminology and reporting criteria—a 10-year update. Radiology. 2014;273:241–60.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Bean WJ. Renal cysts: treatment with alcohol. Radiology. 1981;138:329–31.CrossRefGoogle Scholar
  4. 4.
    Livraghi T, Giorgio A, Marin G, Salmi A, de Sio I, Bolondi L, et al. Hepatocellular carcinoma and cirrhosis in 746 patients: long term results of percutaneous ethanol injection. Radiology. 1985;197:101–8.CrossRefGoogle Scholar
  5. 5.
    Bean WJ, Rodan BA. Hepatic cysts: treatment with alcohol. Am J Radiol. 1985;144:237–41.Google Scholar
  6. 6.
    Solbiati L, Giangrande A, De Pra L, Bellotti E, Cantù P, Ravetto C. Percutaneous ethanol injection of parathyroid tumors under US guidance: treatment for secondary hyperparathyroidism. Radiology. 1985;155:607–10.CrossRefGoogle Scholar
  7. 7.
    Giangrande A, Castiglioni A, Solbiati L, Allaria P. Ultrasound-guided percutaneous fine-needle ethanol injection into parathyroid glands in secondary hyperparathyroidism. Nephrol Dial Transplant. 1992;7(5):412–21.PubMedGoogle Scholar
  8. 8.
    Livraghi T, Paracchi A, Ferrari C, Bergonzi M, Garavaglia G, Raineri P, et al. Treatment of autonomous thyroid nodule with percutaneous ethanol injection: preliminary results. Radiology. 1990;175:827–9.CrossRefGoogle Scholar
  9. 9.
    Martino E, Murtas ML, Loviselli A, Piga M, Petrini L, Miccoli P, et al. Percutaneous intranodular ethanol injection for treatment of autonomously functioning thyroid nodules. Surgery. 1992;112:1161–5.PubMedGoogle Scholar
  10. 10.
    Goletti O, Monzani F, Caraccio N, Del Guerra P, Lippolis PV, Pucciarelli M, et al. Percutaneous ethanol injection treatment of autonomously functioning single thyroid nodules: optimization of treatment and short term outcome. World J Surg. 1992;16:784–9; discussion 789-90.CrossRefGoogle Scholar
  11. 11.
    Papini E, Panunzi C, Pacella CM, Bizzarri G, Fabbrini R, Petrucci L, et al. Percutaneous ultrasound-guided ethanol injection: a new treatment of toxic autonomously functioning thyroid nodules? J Clin Endocrinol Metab. 1993;76:411–6.CrossRefGoogle Scholar
  12. 12.
    Rozman B, Bence-Zigman Z, Tomic-Brzac H, Skreb F, Pavlinovic Z, Simonovic I. Sclerosation of thyroid cysts by ethanol. Period Biol. 1989;91:1116–8.Google Scholar
  13. 13.
    Yasuda K, Ozaki O, Sugino K, Yamashita T, Toshima K, Ito K, et al. Treatment of cystic lesions of the thyroid by ethanol instillation. World J Surg. 1992;16:958–61.CrossRefGoogle Scholar
  14. 14.
    Verde G, Papini E, Pacella CM, et al. Ultrasound guided percutaneous ethanol injection in the treatment of cystic thyroid nodules. Clin Endocrinol. 1994;41:719–24.CrossRefGoogle Scholar
  15. 15.
    Crescenzi A, Papini E, Pacella CM, Rinaldi R, Panunzi C, Petrucci L, et al. Morphological changes in a hyperfunctioning thyroid adenoma after percutaneous ethanol injection: histological, enzymatic and sub-microscopical alterations. J Endocrinol Investig. 1996;19:371–6.CrossRefGoogle Scholar
  16. 16.
    Monzani F, Caraccio N, Basolo F, Iacconi P, LiVolsi V, Miccoli P. Surgical and pathological changes after percutaneous ethanol injection therapy of thyroid nodules. Thyroid. 2000;10:1087–92.CrossRefGoogle Scholar
  17. 17.
    Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedüs L, Paschke R, Valcavi R, Vitti P. AACE/ACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE), and Associazione Medici Endocrinologi (AME) medical guidelines for clinical practice for the diagnosis and management of thyroid nodules- 2016 update. Endocr Pract. 2016;22:622–39.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association (ATA) guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    De Los Santos ET, Keyhani-Rofagha S, Cunningham JJ, et al. Cystic thyroid nodules:the dilemma of malignant lesions. Arch Intern Med. 1990;150:422–7.CrossRefGoogle Scholar
  20. 20.
    Jensen F, Rasmussen SN. The treatment of thyroid cysts by ultrasonographically-guided fine needle aspiration. Acta Chir Scand. 1976;142:209–11.PubMedGoogle Scholar
  21. 21.
    Monzani F, Lippi F, Goletti O, et al. Percutaneous aspiration and ethanol sclerotherapy for thyroid cysts. J Clin Endocrinol Metab. 1994;78:800–2.PubMedGoogle Scholar
  22. 22.
    Antonelli A, Campatelli A, Di Vito A, et al. Comparison between ethanol sclerotherapy and emptying with injection of saline in treatment of thyroid cysts. Clin Investig. 1994;72(12):971–4.CrossRefGoogle Scholar
  23. 23.
    Kim DW. Ultrasound-guided fine-needle aspiration of benign thyroid cysts or partially cystic thyroid nodules: a preliminary study for factors predicting successful collapse. Endocrine. 2014;45:67–72.CrossRefGoogle Scholar
  24. 24.
    Bandeira-Echtler E, Bergerhoff K, Richter B. Levothyroxine or minimally invasive therapies for benign thyroid nodules. Cochrane Database Syst Rev. 2014;6:CD004098.Google Scholar
  25. 25.
    Bennedbaek FN, Hegedus L. Treatment of recurrent thyroid cysts with ethanol: a randomized double blind controlled trial. J Clin Endocrinol Metab. 2003;88:5773–7.CrossRefGoogle Scholar
  26. 26.
    Valcavi R, Frasoldati A. Ultrasound-guided percutaneous ethanol injection therapy in thyroid cystic nodules. Endocr Pract. 2004;10:269–75.CrossRefGoogle Scholar
  27. 27.
    Del Prete S, Caraglia M, Russo D, Vitale G, Giuberti G, Marra M, et al. Percutaneous ethanol injection efficacy in the treatment of large symptomatic thyroid cystic nodules: ten-year follow-up of a large series. Thyroid. 2002;12:815–21.CrossRefGoogle Scholar
  28. 28.
    Guglielmi R, Pacella CM, Bianchini A, Bizzarri G, Rinaldi R, Graziano FM, et al. Percutaneous ethanol injection treatment in benign thyroid lesions: role and efficacy. Thyroid. 2004;14:125–31.CrossRefGoogle Scholar
  29. 29.
    Kim JH, Lee HK, Lee JH, Ahn IM, Choi CG. Efficacy of sonographically guided percutaneous ethanol injection for treatment of thyroid cysts versus solid thyroid nodules. Am J Roentgenol. 2003;180:1623–726.Google Scholar
  30. 30.
    Zingrillo M, Torlontano M, Chiarella R, et al. Percutaneous ethanol injection may be a definitive treatment for symptomatic thyroid cystic nodules not treatable by surgery: five-year follow-up study. Thyroid. 1999;9:763–7.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Lee SJ, Ahn I-M. Effectiveness of percutaneous ethanol injection therapy in benign nodular and cystic thyroid disease: long-term follow-up experience. Endocr J. 2005;52:455–62.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Kanotra SP, Lateef M, Kirmani O. Non-surgical management of benign thyroid cysts: use of ultrasound-guided ethanol ablation. Postgrad Med J. 2008;84(998):639–43.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Sung JY, Kim YS, Choi H, et al. Optimum first-line treatment technique for benign cystic thyroid nodules: ethanol ablation or radiofrequency ablation. AJR Am J Roentgenol. 2011;196(2):W210–4.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Porenta M, Fettich JJ. Treatment of thyroid cysts by sclerosation. Radiobiol Radiother. 1985;26:249–54.Google Scholar
  35. 35.
    Hegedüs L, Hansen JM, Karstrup S, Torp-Pedersen S, Juul N. Tetracycline for sclerosis of thyroid cysts. A randomized study. Arch Intern Med. 1988;148(5):1116–8.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Kalra N, Ahuja CK, Dutta P, Rajwanshi A, Mittal BR, Bhansali A, et al. Comparison of sonographically guided percutaneous sodium tetradecyl sulfate injection with ethanol injection in the treatment of benign nonfunctioning thyroid nodules. J Vasc Interv Radiol. 2014;25:1218–24.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Zhao Y, Guan X, Liu Y, Liu S, Hussain A, Shi B. The efficacy of percutaneous AHI (arginine hydrochloride injection) for the treatment of recurrent thyroid cysts. Ann Endocrinol. 2015;76:281–5.CrossRefGoogle Scholar
  38. 38.
    Reverter JL, Alonso N, Avila M, Lucas A, Mauricio D, Puig-Domingo M. Evaluation of efficacy, safety, pain perception and health-related quality of life of percutaneous ethanol injection as first-line treatment in symptomatic thyroid cysts. BMC Endocr Disord. 2015;15:73.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    In HS, Kim DW, Choo HJ, Jung SJ, Kang T, Ryu JH. Ethanol ablation of benign thyroid cysts and predominantly cystic thyroid nodules: factors that predict outcome. Endocrine. 2014;46:107–13.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Cho YS, Lee HK, Ahn IM, Lim SM, Kim DH, Choi CG, et al. Sonographically guided ethanol sclerotherapy for benign thyroid cysts: results in 22 patients. AJR Am J Roentgenol. 2000;174:213–6.CrossRefGoogle Scholar
  41. 41.
    Kim DW, Rho MH, Park HJ, Kwag HJ. Ultrasonography-guided ethanol ablation of predominantly solid thyroid nodules: a preliminary study for factors that predict the outcome. Br J Radiol. 2012;85:930–6.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Kim YJ, Baek JH, Ha EJ, Lim HK, Lee JH, Sung JY, et al. Cystic versus predominantly cystic thyroid nodules: efficacy of ethanol ablation and analysis of related factors. Eur Radiol. 2012;22:1573–8.CrossRefGoogle Scholar
  43. 43.
    Baek JH, Ha EJ, Choi YJ, Sung JY, Kim JK, Shong YK. Radiofrequency versus ethanol ablation for treating predominantly cystic thyroid nodules: a randomized clinical trial. Korean J Radiol. 2015;16:1332–40.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Suh CH, Baek JH, Ha EJ, Choi YJ, Lee JH, Kim JK, et al. Ethanol ablation of predominantly cystic thyroid nodules: evaluation of recurrence rate and factors related to recurrence. Clin Radiol. 2015;70:42–7.CrossRefGoogle Scholar
  45. 45.
    Kim DW. Usefulness of two-stage ethanol ablation in the treatment of benign predominantly cystic thyroid nodules. Endocr Pract. 2014;20:548–55.CrossRefGoogle Scholar
  46. 46.
    Zingrillo M, Torlantano M, Ghiggi MR, D’Aloiso L, Nirchino V, Bisceglia M, et al. Percutaneous ethanol injection of large thyroid cystic nodules. Thyroid. 1996;6:403–8.CrossRefGoogle Scholar
  47. 47.
    Zieleźnik W, Kawczyk-Krupka A, Peszel Barlik M, Cebula W, Sieroń A. Modified percutaneous ethanol injection in the treatment of viscous cystic thyroid nodules. Thyroid. 2005;15:683–7.CrossRefGoogle Scholar
  48. 48.
    Sung JY, Baek JH, Kim YS, Jeong HJ, Kwak MS, Lee D, Moon W. One-step ethanol ablation viscous cystic thyroid nodules. AJR. 2008;191:1730–173.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Lv G, Chen S, Li B, Chen X, Li S. Efficacy assessment of newly developed open-window intervention needles for the treatment of cystic thyroid nodules that cannot be aspirated. Thyroid. 2014;24:1012–7.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Kim DW, Rho MH, Kim HJ, Kwon JS, Sung YS, Lee SW. Percutaneous ethanol injection for benign cystic thyroid nodules: is aspiration of ethanol-mixed fluid advantageous? AJNR Am J Neuroradiol. 2005;26:2122–7.PubMedPubMedCentralGoogle Scholar
  51. 51.
    Monzani F, Goletti O, Caraccio N, Del Guerra P, Ferdeghini M, Pucci E, et al. Percutaneous ethanol injection treatment of autonomous thyroid adenoma: hormonal and clinical evaluation. Clin Endocrinol. 1992;36:491–7.CrossRefGoogle Scholar
  52. 52.
    Di Lelio A, Rivolta M, Casati M, Capra M. Treatment of autonomous thyroid nodules: value of percutaneous ethanol injection. Am J Roentgenol. 1995;164:207–13.CrossRefGoogle Scholar
  53. 53.
    Ferrari C, Reschini E, Paracchi A. Treatment of the autonomous thyroid nodule: a review. Eur J Endocrinol. 1996;135:383–90.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Lippi F, Ferrari C, Manetti L, Rago T, Santini F, Monzani F, et al. Treatment of solitary autonomous thyroid nodules by percutaneous etanol injection. Results of an Italian multicenter study. J Clin Endocrinol Metab. 1996;81:3261–4.PubMedPubMedCentralGoogle Scholar
  55. 55.
    Monzani F, Caraccio N, Goletti O. Five year follow-up of percutaneous ethanol injection for the treatment of hyperfunctioning thyroid nodules: a study of 117 patients. Clin Endocrinol. 1997;46:9–15.CrossRefGoogle Scholar
  56. 56.
    Zingrillo M, Torlontano M, Ghiggi MR, Frusciante V, Varraso A, Liuzzi A, et al. Radioiodine and percutaneous ethanol injection in the treatment of large toxic thyroid nodule: a long-term study. Thyroid. 2000;10:985–9.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Del Prete S, Russo D, Caraglia M, Giuberti G, Marra M, Vitale G, et al. Percutaneous ethanol injection of autonomous thyroid nodules with a volume larger than 40 ml: three years of follow-up. Clin Radiol. 2001;56:895–901.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Tarantino L, Francica G, Sordelli I, Sperlongano P, Parmeggiani D, Ripa C, et al. Percutaneous ethanol injection of hyperfunctioning thyroid nodules: long-term follow-up in 125 patients. AJR Am J Roentgenol. 2008;190:800–8.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Yano Y, Sugino K, Akaishi J, Uruno T, Okuwa K, Shibuya H, et al. Treatment of autonomously functioning thyroid nodules at a single institution: radioiodine therapy, surgery, and ethanol injection therapy. Ann Nucl Med. 2011;25:749–54.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Zingrillo M, Modoni S, Conte M, Frusciante V, Trischitta V. Percutaneous ethanol injection plus radioiodine versus radioidine alone in the treatment of large toxic thyroid nodules. J Nucl Med. 2003;44:207–10.PubMedPubMedCentralGoogle Scholar
  61. 61.
    Pacini F. Role of percutaneous ethanol injection in management of nodular lesions of the thyroid gland. J Nucl Med. 2003;44:211–2.PubMedPubMedCentralGoogle Scholar
  62. 62.
    Pishdad GR, Pishdad P, Pishdad R. Horner’s syndrome as a complication of percutaneous ethanol treatment of thyroid nodule. Thyroid. 2011;21:327–8.CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Regalbuto C, Le Moli R, Muscia V, Russo M, Vigneri R, Pezzino V. Severe graves’ ophthalmopathy after percutaneous ethanol injection in a nontoxic thyroid nodule. Thyroid. 2012;22:210–3.CrossRefPubMedPubMedCentralGoogle Scholar
  64. 64.
    Zingrillo M, Collura D, Ghiggi MR, Nirchio V, Trischitta V. Treatment of large cold benign thyroid nodules not eligible for surgery with percutaneous ethanol injection. J Clin Endocrinol Metab. 1998;83:3905–7.CrossRefPubMedPubMedCentralGoogle Scholar
  65. 65.
    Bennedbaek FN, Nielsen LK, Hegedus L. Effect of percutaneous ethanol injection therapy versus suppressive doses of L-thyroxine on benign solitary solid cold thyroid nodules: a randomized trial. J Clin Endocrinol Metab. 1998;83:830–5.CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Bennedbaek FN, Hegedüs L. Percutaneous ethanol injection therapy in benign solitary solid cold thyroid nodules: a randomized trial comparing one injection with three injections. Thyroid. 1999;9:225–33.CrossRefPubMedPubMedCentralGoogle Scholar
  67. 67.
    Papini E, Pacella CM, Hegedus L. Diagnosis of endocrine disease: thyroid ultrasound (US) and US-assisted procedures: from the shadows into an array of applications. Eur J Endocrinol. 2014;170:R133–46.CrossRefPubMedPubMedCentralGoogle Scholar
  68. 68.
    Papini E, Pacella CM, Misischi I, Guglielmi R, Bizzarri G, Døssing H, et al. The advent of ultrasound-guided ablation techniques in nodular thyroid disease: towards a patient-tailored approach. Best Pract Res Clin Endocrinol Metab. 2014;28:601–18.CrossRefPubMedPubMedCentralGoogle Scholar
  69. 69.
    Douthat WG, Cardozo G, Garay G, Orozco S, Chiurchiu C, de la Fuente J, et al. Use of percutaneous ethanol injection therapy for recurrent secondary hyperparathyroidism after subtotal parathyroidectomy. Int J Nephrol. 2011;2011:246734.CrossRefPubMedPubMedCentralGoogle Scholar
  70. 70.
    Chen HH, Lin CJ, Wu CJ, Lai CT, Lin J, Cheng SP, et al. Chemical ablation of recurrent and persistent secondary hyperparathyroidism after subtotal parathyroidectomy. Ann Surg. 2011;253:786–90.CrossRefGoogle Scholar
  71. 71.
    Kitaoka M. Ultrasonographic diagnosis of parathyroid glands and percutaneous ethanol injection therapy. Nephrol Dial Transplant. 2003;18(Suppl 3):ii27–30.PubMedGoogle Scholar
  72. 72.
    Tanaka M, Itoh K, Matsushita K, Matsushita K, Fukagawa M. Efficacy of percutaneous ethanol injection therapy for secondary hyperparathyroidism in patients on hemodialysis as evaluated by parathyroid hormone levels according to K/DOQI guidelines. Ther Apher Dial. 2005;9:48–52.CrossRefGoogle Scholar
  73. 73.
    Douthat WG, Chiurchiu CR, Massari PU. New options for the management of hyperparathyroidism after renal transplantation. World J Transplant. 2012;2(3):41–5.CrossRefPubMedPubMedCentralGoogle Scholar
  74. 74.
    Harman CR, Grant CS, Hay ID, et al. Indications, technique, and efficacy of alcohol injection of enlarged parathyroid glands in patients with primary hyperparathyroidism. Surgery. 1998;124:1011–9.CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Cercueil JP, Jacob D, Verges B, Holtzmann P, Lerais JM, Krause D. Percutaneous ethanol injection into parathyroid adenomas: mid- and long-term results. Eur Radiol. 1998;8:1565–156.CrossRefPubMedPubMedCentralGoogle Scholar
  76. 76.
    Singh Ospina N, Thompson GB, Lee RA, Reading CC, Young WF Jr. Safety and efficacy of percutaneous parathyroid ethanol ablation in patients with recurrent primary hyperparathyroidism and multiple endocrine Neoplasia type 1. J Clin Endocrinol Metabol. 2015;100(1):E87–90.CrossRefGoogle Scholar
  77. 77.
    Clark OH, Okerlund MD, Cavalieri RR, Greenspan FS. Diagnosis and treatment of thyroid parathyroid and thyroglossal duct cysts. J Clin Endocrinol Metab. 1979;48:983–8.CrossRefPubMedPubMedCentralGoogle Scholar
  78. 78.
    Ippolito G, Palazzo FF, Sebag F, Sierra M, De Micco C, Henry JF. A single institution 25-year review of true parathyroid cysts. Langenbecks Arch Surg. 2006;391:13–8.CrossRefPubMedPubMedCentralGoogle Scholar
  79. 79.
    Goomany A, Rafferty A, Smith I. An unusual neck mass: a case of a parathyroid cyst and review of the literature. Case Rep Surg. 2015;2015:243527.PubMedPubMedCentralGoogle Scholar
  80. 80.
    Prinz RA, Peters JR, Kane JM, Wood J. Needle aspiration of nonfunctioning parathyroid cysts. Am Surg. 1990;56:420–2.PubMedGoogle Scholar
  81. 81.
    Akel M, Salti I, Azar ST. Successful treatment of parathyroid cyst using ethanol sclerotherapy. Am J Med Sci. 1999;317:50–2.CrossRefGoogle Scholar
  82. 82.
    Baskin HJ. New applications of thyroid and parathyroid ultrasound. Minerva Endocrinol. 2004;29:195–206.PubMedGoogle Scholar
  83. 83.
    Frasoldati A, Valcavi R. Challenges in neck ultrasonography: lymphadenopathy and parathyroid glands. Endocr Pract. 2004;10:261–8.CrossRefGoogle Scholar
  84. 84.
    Koiwa F, Hasegawa T, Tanaka R, Kakuta T. Indication and efficacy of PEIT in the management of secondary hyperparathyroidism. NDT Plus. 2008;1(Suppl 3):14–7.Google Scholar
  85. 85.
    Sung JY, Baek JH, Kim KS, Lee D, Ha EJ, Lee JH. Symptomatic nonfunctioning parathyroid cysts: role of simple aspiration and ethanol ablation. Eur J Radiol. 2013;82:316–20.CrossRefGoogle Scholar
  86. 86.
    Kim JH. Ultrasound-guided sclerotherapy for benign non-thyroid cystic mass in the neck. Ultrasonography. 2014;33:83–90.CrossRefPubMedPubMedCentralGoogle Scholar
  87. 87.
    Hay ID, Charboneau JW. The coming of age of ultrasound-guided percutaneous ethanol ablation of selected neck nodal metastases in well-differentiated thyroid carcinoma. J Clin Endocrinol Metab. 2011;96:2717–20.CrossRefGoogle Scholar
  88. 88.
    Lewis BD, Hay ID, Charboneau JW, McIver B, Reading CC, Goellner JR. Percutaneous ethanol injection for treatment of cervical lymph node metastases in patients with papillary thyroid carcinoma. Am J Roentgenol. 2002;178:699–704.CrossRefGoogle Scholar
  89. 89.
    Monchik JM, Donatini G, Iannuccilli J, Dupuy DE. Radiofrequency ablation and percutaneous ethanol injection treatment for recurrent local and distant well-differentiated thyroid carcinoma. Ann Surg. 2006;244:296–304.CrossRefPubMedPubMedCentralGoogle Scholar
  90. 90.
    Lim CY, Yun JS, Lee J, Nam KH, Chung WY, Park CS. Percutaneous ethanol injection therapy for locally recurrent papillary thyroid carcinoma. Thyroid. 2007;17:347–35.CrossRefGoogle Scholar
  91. 91.
    Kim BM, Kim MJ, Kim EK, et al. Controlling recurrent papillary thyroid carcinoma in the neck by ultrasonography-guided percutaneous ethanol injection. Eur Radiol. 2008;18:835–42.CrossRefGoogle Scholar
  92. 92.
    Heilo A, Sigstad E, Fagerlid KH, Håskjold OI, Grøholt KK, Berner A, et al. Efficacy of ultrasound-guided percutaneous ethanol injection treatment in patients with a limited number of metastatic cervical lymph nodes from papillary thyroid carcinoma. J Clin Endocrinol Metab. 2011;96:2750–5.CrossRefGoogle Scholar
  93. 93.
    Hay ID, Lee RA, Davidge-Pitts C, Reading CC, Charboneau JW. Long-term outcome of ultrasound-guided percutaneous ethanol ablation of selected “recurrent” neck nodal metastases in 25 patients with TNM stages III or IVA papillary thyroid carcinoma previously treated by surgery and 131I therapy. Surgery. 2013;154:1448–54; discussion 1454-5.CrossRefGoogle Scholar
  94. 94.
    Guenette JP, Monchik JM, Dupuy DE. Image-guided ablation of postsurgical locoregional recurrence of biopsy-proven well-differentiated thyroid carcinoma. J Vasc Interv Radiol. 2013;24(5):672–9.CrossRefGoogle Scholar
  95. 95.
    Vannucchi G, Covelli D, Perrino M, De Leo S, Fugazzola L. Ultrasound-guided percutaneous ethanol injection in papillary thyroid cancer metastatic lymph-nodes. Endocrine. 2014;47:648–51.CrossRefGoogle Scholar
  96. 96.
    Fontenot TE, Deniwar A, Bhatia P, Al-Qurayshi Z, Randolph GW, Kandil E. Percutaneous ethanol injection vs reoperation for locally recurrent papillary thyroid cancer: a systematic review and pooled analysis. JAMA Otolaryngol Head Neck Surg. 2015;141:512–8.CrossRefGoogle Scholar
  97. 97.
    Sohn YM, Hong SW, Kim EK, Kim MJ, Moon HJ, Kim SJ, et al. Complete eradication of metastatic lymph node after percutaneous ethanol injection therapy: pathologic correlation. Thyroid. 2009;19:317–9.CrossRefGoogle Scholar
  98. 98.
    Pacella CM, Papini E. Image-guided percutaneous ablation therapies for local recurrences of thyroid tumors. J Endocrinol Investig. 2013;36:61–70.CrossRefGoogle Scholar
  99. 99.
    Yue W, Chen L, Wang S, Yu S. Locoregional control of recurrent papillary thyroid carcinoma by ultrasound-guided percutaneous microwave ablation: a prospective study. Int J Hyperth. 2015;3:403–8.CrossRefGoogle Scholar
  100. 100.
    Lim HK, Baek JH, Lee JH, Kim WB, Kim TY, Shong YK, et al. Efficacy and safety of radiofrequency ablation for treating locoregional recurrence from papillary thyroid cancer. Eur Radiol. 2015;25:163–70.CrossRefGoogle Scholar

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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