Treatment of hyperfunctioning thyroid nodules by percutaneous ethanol injection

<p>Abstract</p> <p>Background</p> <p>Autonomous thyroid nodules can be treated by a variety of methods. We assessed the efficacy of percutaneous ethanol injection in treating autonomous thyroid nodules.</p> <p>Methods</p> <p>35 patients diagnosed...

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Main Authors: Sarai Maryam, Amini Mohammad-Reza, Shirzad Mahmood, Firooznia Kazem, Abbasvandi Fereshteh, Bastanhagh Mohammad-Hassan, Ghanaati Hossein, Pajouhi Mohammad, Larijani Bagher, Abbasvandi Nasreen, Baradar-Jalili Reza
Format: Article
Language:English
Published: BMC 2002-12-01
Series:BMC Endocrine Disorders
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Online Access:http://www.biomedcentral.com/1472-6823/2/3
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Summary:<p>Abstract</p> <p>Background</p> <p>Autonomous thyroid nodules can be treated by a variety of methods. We assessed the efficacy of percutaneous ethanol injection in treating autonomous thyroid nodules.</p> <p>Methods</p> <p>35 patients diagnosed by technetium-99 scanning with hyperfunctioning nodules and suppressed sensitive TSH (sTSH) were given sterile ethanol injections under ultrasound guidance. 29 patients had clinical and biochemical hyperthyroidism. The other 6 had sub-clinical hyperthyroidism with suppressed sTSH levels (<0.24 μIU/ml) and normal thyroid hormone levels. Ethanol injections were performed once every 1–4 weeks. Ethanol injections were stopped when serum T<sub>3</sub>, T<sub>4 </sub>and sTSH levels had returned to normal, or else injections could no longer be performed because significant side effects. Patients were followed up at 3, 6 and, in 15 patients, 24 months after the last injection.</p> <p>Results</p> <p>Average pre-treatment nodule volume [18.2 ± 12.7 ml] decreased to 5.7 ± 4.6 ml at 6 months follow-up [P < 0.001]. All patients had normal thyroid hormone levels at 3 and 6 months follow-up [P < 0.001 relative to baseline]. sTSH levels increased from 0.09 ± 0.02 μIU/ml to 0.65 ± 0.8 μIU/ml at the end of therapy [P < 0.05]. Only 3 patients had persistent sTSH suppression at 6 months post-therapy. T<sub>4 </sub>and sTSH did not change significantly between 6 months and 2 years [P > 0.05]. Ethanol injections were well tolerated by the patients, with only 2 cases of transient dysphonia.</p> <p>Conclusion</p> <p>Our findings indicate that ethanol injection is an alternative to surgery or radioactive iodine in the treatment of autonomous thyroid nodules.</p>
ISSN:1472-6823