Treatment of solitary autonomous thyroid nodules by percutaneous ethanol injection: results of an Italian multicenter study. The Multicenter Study Group.

We propose Percutaneous intranodular ethanol injection treatment for nodules of lessthan 15mL volume, while it can be considered an alternative to radioiodine for nodules between 15 and 30 mL volume, especially in young patients

F Lippi; C Ferrari; L Manetti; T Rago; F Santini; F Monzani; P Bellitti; E Papini; B Busnardo; F Angelini; A Pinchera


Scholarcy highlights

  • 1992, an Italian multicenter study was undertaken to confirm the usefulness and the feasibility of this procedure
  • The treatment was judged successfulwhen both thyroid stimulating hormone and free thyroid hormone serum levels returned within the normal range, and recovery of tracer uptake in extranodular tissue was observed at scintiscan
  • The treatment was considered unsuccessful when no change was observed at scintiscan and/ or serum TSH levels remained less than 0.4 mu/L
  • Successfulresultswere obtained in 104out of 242patients with toxic adenoma and in 93 out of 187 patients with pretoxic adenoma at 3 months after Percutaneous intranodular ethanol injection; in 148 out of 242 and in 145out of 187(77.5%)at 6 months; in 161 out of 242 and 156out of 187 at 12 months in TA and in PTA, respectively.The proportion of successfulresultswas very high in nodules smaller than 15 mL and decreasedin bigger nodules.There was no correlation between the number of sessionand the proportion of successfulresults
  • Antithyroid drugs are not indicated for definitive treatment of autonomously functioning thyroid nodules becauseof universal relapseof hyperthyroidism at a time when thionamides are discontinued
  • Radioiodine is effective in treating hyperthyroidism causedby toxic adenoma and partially reduces the nodular volume
  • Because of the low proportion of successful results, Percutaneous intranodular ethanol injection treatment should not be performed in nodules larger than 30 mL

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