Background/Aim. According to the current principles, autonomous functional
thyroid nodules are treated by surgery or by radioiodin therapy. Ultrasound
guided percutaneous ethanol injection into solid tumors of the soft tissues
was a starting point in attempts to treat the thyroid nodules by the same
method. The aim of the study was to assess the efficiency of percutaneous
injection in treating solitary, nontoxic, autonomous thyroid nodules of up to
15 mL volume. Methods. In 25 patients with solitary nontoxic autonomous
thyroid nodules diagnosed by tehnetium-99m scanning as an intensive area
having a complete supremacy in the paranodal tissue, an ultrasound guided
percutaneous ethanol injection was applied. The procedure was carried out
repeatedly once a week until the reduction in nodule size to 50% of the
initial size was achieved. Results. An average size of the nodule before
curing was 9.68 ? 5.01 mL. An average quantity of the injected ethanol was
9.52 ? 5.08 mL, ie 1.06 ? 0.48 mL/mg of the tissue. The regression of the
nodule size in the successfully (?vol% u = - 57.09 ? 13.75%, p < 0.001) and
partly successfully cured (?vol du = -48.45 ? 14.35%, p < 0.05) was
statistically significant compared to the size before the treatment. After
ceasing ethanol injection, 18 months later, a further size regression (?vol%
= -79.20 ? 9.89%) compared to the initial one (p < 0.001) was noticed. Soon,
after the procedure was finished, a statistically significant concentration
increase of Thyroid Stimulating Hormone (TSH) was noticed compared to the
initial values (0.18 ? 0.16 vs 0.34 ? 0.31 mU/L, p < 0.01). According to the
given criteria, in two female patients satisfactory results were not
achieved, but, a year later, in one of them the nodule was not seen by
repeated scintigram. The number and frequency of side effects were
insignificant. Conclusion. Repeated percutaneous ethanol injections into
nontoxic solitary autonomous thyroid nodules result in disappearing of
authonomy. The regression of the nodule size of more than 50% compared to its
initial volume, as well as the increase in concentration of TSH for more than
50% are the signs of a successful treatment.
Possibilities of nontoxic autonomous thyroid nodules treatment by percutaneous ethanol injection
