Percutaneous ethanol injection treatment of benign solid and mixed thyroid nodules
Abstract
Introduction: Nodular goiter is generally benign and asymptomatic. Symptoms in patients with this diagnosis develop primarily due to an increase in the volume of the nodules, which can cause asymmetry of the neck upon inspection and manifest only as aesthetic problems, causing discomfort when swallowing, or symptoms of compression.
Objective: To show the results of treatment with percutaneous ethanol injection in patients with benign nontoxic nodular goiter and dominant solid and mixed thyroid nodules.
Methods: A prospective, longitudinal study was conducted in 51 patients diagnosed with benign nontoxic nodular goiter with dominant solid and mixed nodules treated with percutaneous ethanol injection. Qualitative variables were described by absolute frequencies and percentages. Quantitative variables were described through average and standard deviation. Student's t-test for related samples was used to evaluate changes between the initial and final volumes of the nodules. Data were entered and analyzed in IBM SPSS 23. A confidence level of 95% was used.
Results: The average age of the patients was 50.72 ± 11.61, with a predominance of females (75.9%). The efficacy of the technique was 100%, and clinical success was complete in 100% of the patients at twelve months of follow-up. Burning was the most frequent side effect (66.7%). There were no complications.
Conclusions: Treatment with percutaneous ethanol injection in benign solid and mixed thyroid nodules decreases nodular volume and eliminates the symptoms reported by patients, with transient adverse effects and very rare complications.
DeCS: GOITER, NODULAR/ drug therapy; THERAPEUTICS; SIGNS AND SYMPTOMS; TREATMENT OUTCOME; ETHANOL/ therapeutic use.
Downloads
References
1. Taner Unlu M, Kostek M, Aygun N, Isgor A, Uludag M. Non-Toxic Multinodular Goiter: From Etiopathogenesis to Treatment. Med Bull SisliEtfalHosp [Internet]. 2022 [cited 17 Nov 2024];56(1):21–40. Disponible en:10.14744/SEMB.2022.56514
2. Alcántara-Jones DMD, Borges LMB, Nunes TFA, Pita GB, Rocha VB, Lavinas JM, et al. Percutaneous injection of ethanol for thyroid nodule treatment: a comparative study. Archives of Endocrinology and Metabolism [Internet]. 2021 [citado 17 Nov 2024]; 65(3): 322-327. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33939906/
3. He L, Zhao W, Xia Z, Su A, Li Z, Zhu J. Comparative efficacy of different ultrasound-guided ablation for the treatment of benign thyroid nodules: Systematic review and network meta-analysis of randomized controlled trials. PLoS ONE [Internet]. 2021 [citado 17 Nov 2024]; 16(1): e0243864. Disponible en: https://doi.org/10.1371/journal.pone.0243864
4. Papini E, Monpeyssen H, Frasoldati A, Hegedüs L. 2020 European Thyroid Association Clinical Practice Guide line for the Use of Image-Guided Ablation in Benign Thyroid Nodules. Eur Thyroid J [Internet]. 2020 [citado 17 Nov 2024]; 9:172–85. Disponible en:10.1159/000508484
5. Baldwin CK, Natter MB, Patel KN, Hodak SP. Minimally Invasive Techniques for the Management of Thyroid Nodules. Endocrinology and Metabolism Clinics [Internet]. 2022 [citado 17 Nov 2024]; 51(2):323-49. Disponible en: 10.1016/j.ecl.2022.01.001
6. Papini E, Maurizio C, Alessandro L, Achille G, Barbaro D, Bernardi S; et al. Minimally-invasive treatments for benign thyroid nodules: a Delphi-based consensus statement fromthe Italian minimally-invasive treatments of the thyroid (MITT) group. International Journal of Hyperthermia [Internet]. 2019 [citado 17 Nov 2024]; 36(1): 375-381. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30909759/
7. Miracle-López S, Rodríguez-Ayala E, Sánchez Alanís CA. Tratamiento con inyección percutánea con etanol (PEIT) de nódulos tiroideos sólidos benignos. Eficacia y experiencia en México. Rev. Mex Endocrinol Metab Nutr [Internet]. 2020 [citado 17 Nov 2024]; 7:113-21. Disponible en: 10.24875/RME.20000015
8. Miracle-López S, Rodríguez-Ayala E, Sánchez-Alanís ÁC. Análisis de costo-minimización del tratamiento por inyección percutánea con etanol de nódulos tiroideos sólidos benignos: estudio piloto exploratorio. Cirugía y cirujanos [Internet]. 2022 [citado 17 Nov 2024]; 90(6): 804-12. Disponible en: 10.24875/CIRU.21000230
9. Mauri G, Papini E, Solbiati L, Muneeb Ahmed, Apostolorum R. Image-guided Thyroid Ablation: Proposal for Standardization of Terminology and Reporting Criteria. Thyroid [Internet]. 2019 [citado 17 Nov 2024]; 29(5): 611-618. Disponible en: 10.1089/thy.2018.0604
10. Merchante AÁ, Garzón S, Pérez S, González M, Blanco J, Maravall FJ, et al. Percutaneous ethanol injection therapy as the first line of treatment of symptomatic thyroid cysts. Endocrinologia, Diabetes y Nutricion. [Internet] 2021 [citado 11 Nov 2024];68(7):458-464. Disponible en: 1
0.1016/j.endien.2021.11.011. PMID: 34863410.
11. Cho W, Sim JS, Jung SL. Ultrasound-guided ethanol ablation for cystic thyroid nodules: effectiveness of small amounts of ethanol in a single session. Ultrasonography [Internet]. 2021 [citado 11 Nov 2024]; 40(3): 417-427. Disponible en: 10.14366/usg.20170
12. Siddappa AK, Kadli SU, Kailas CT, Chandrasekhar RL. A study on management of multinodular goiter at a tertiary care hospital. International Journal of Surgery [Internet]. 2019 [citado 11 Nov 2024]; 3(3): 186-189. Disponible en: 10.33545/surgery.2019.v3.i3d.166
13. Ferreira MC, Piaia C, Cadore AC. Percutaneous ethanol injection versus conservative treatment for benign cystic and mixed thyroid nodules. Archives of Endocrinology and Metabolism [Internet]. 2016 [citado 11 Nov 2024]; 60(3): 211-216. Disponible en: 10.1590/2359-3997000000120
14. Ahmed MT, Kotb M, Shahine MS, Harby HM, Mohamed MT. Percutaneous ethanol injection for benign cystic thyroid nodules. Journal of Current Medical Research and Practice [Internet]. 2018 [citado 11 Nov 2024]; 3(2): 110-114. Disponible en: 10.4103/JCMRP.JCMRP_95_18
15. Felício JS, Conceição AMS, Santos FM, Sato MMM, Bastos FdA, Braga de Souza ACC; et al. Ultrasound-Guided Percutaneous Ethanol Injection Protocol to Treat Solid and Mixed Thyroid Nodules. Front Endocrinol [Internet]. 2016 [citado 11 Nov 2024];7: 52. Disponible en: 10.3389/fendo.2016.00052
16. Solymosi T. Percutaneous ethanol injection efficacy in the treatment of benign thyroid nodules. Ten-year follow-up of 254 patients. OrvosiHetilap [Internet]. 2020 [citado 11 Nov 2024]; 161(6): 224-231. Disponible en: 10.1556/650.2020.31658
17. Cesareo R, Tabacco G, Naciu AM, Crescenzi A, Bernardi S, Romanelli F; et al. Long‐term efficacy and safety of percutaneous ethanol injection (PEI) in cystic thyroid nodules: A systematic review and meta‐analysis. Clinical Endocrinology [Internet]. 2022 [citado 11 Nov 2024]; 96(2): 97-106. Disponible en: 10.1111/cen.14530
18. Lorda-Galiano L, Navas-Igarza J, Ortega-de-la-Campa B. Consideraciones actuales de la inyección percutánea de etanol en el bocio nodular benigno. Rev cuban med mil [Internet]. 2023 [citado 22 Sep 2023]; 52(3). Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/2930
19. Karatay E, Javadov M. Comparison of volumetric and cosmetic scoring changes after treatment of benignthyroid nodules using microwave ablation and ethanol ablation therapy. Acta Med Alanya [Internet]. 2021 [citado 11 Nov 2024];5(1):87-92. Disponible en:10.30565/medalanya.874438
20. Hahn SY, Shin JH, Na DG, Ha EJ, Ahn HS, Lim HK; et al. Ethanol ablation of the thyroid nodules: 2018 consensus statement by the Korean Society of Thyroid Radiology. Korean journal of radiology [Internet]. 2019 [citado 11 Nov 2024]; 20(4):609-20. Disponible en: 10.3348/kjr.2018.0696
Published
How to Cite
Issue
Section
License
Copyright: Camagüey Medical Archive Magazine, offers immediately after being indexed in the SciELO Project; Open access to the full text of the articles under the principle of making available and free the research to promote the exchange of global knowledge and contribute to a greater extension, publication, evaluation and extensive use of the articles that can be used without purpose As long as reference is made to the primary source.
Conflicts of interest: authors must declare in a mandatory manner the presence or not of conflicts of interest in relation to the investigation presented.
(Download Statement of potential conflicts of interest)
The Revista Archivo Médico de Camagüey is under a License Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 International (CC BY 4.0).
This license allows others to distribute, to mix, to adjust and to build from its work, even for commercial purposes, as long as it is recognized the authorship of the original creation. This is the most helpful license offered. Recommended for maximum dissemination and use of licensed materials. The full license can be found at: https://creativecommons.org/licenses/
22 julio 2025