Successful ultrasound-guided percutaneous ethanol injection therapy of thyroid cysts in adolescents

Česká verzia

Authors: M. Halenka ¹; Z. Fryšák ¹; H. Munteanu ²; O. Veselý ³; P. Venháčová ³; J. Zapletalová ³
Authors place of work: III. interní klinika – nefrologická, revmatologická, endokrinologická, FN a LF UP Olomouc ¹; Interní gastroenterologická klinika FN Brno – Bohunice ²; Dětská klinika, FN a LF UP Olomouc ³
Published in the journal: Čes-slov Pediat 2020; 75 (2): 108-113.
Category: Review

Summary

Ultrasound-guided Percutaneous Ethanol Injection Therapy (US-PEIT) has been already established as a routine and safe treatment of symptomatic thyroid cysts as an alternative to surgery. Preferably it can be used in young women and girls who refuse surgery. We present a series of case reports of six girls, where this method achieved a cyst volume reduction rate (VRR) of 93% and the disappearance of the fluid component. For successful US-PEIT of thyroid cysts was sufficient to use relatively small total amounts of ethanol, corresponding to 19% of the initial cyst volume. Two sclerotizations per cyst were needed. The patients avoided surgery. The great advantage of the method is that there is no subsequent lifetime substitution of thyroid hormones.

Keywords:

thyroid cysts – ultrasound-guided percutaneous ethanol injection therapy

Zdroje

1. Sheppard MC, Franklyn JA. Management of the single thyroid nodule. Clin Endocrinol (Oxf) 1992; 37: 398–401.

2. Moon WJ, Baek JH, Jung SL, et al. Korean Society of Thyroid Radiology (KSThR); Korean Society of Radiology. Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean J Radiol 2011; 12: 1–14.

3. Bennedbaek FN, Hegedüs L. Treatment of recurrent thyroid cysts with ethanol: a randomized double-blind controlled trial. J Clin Endocrinol Metab 2003; 88: 5773–5777.

4. Kim DW, Rho MH, Kim HJ, et al. Percutaneous ethanol injection for benign cystic thyroid nodules: is aspiration of ethanol-mixed fluid advantageous? AJNR Am J Neuroradiol 2005; 26: 2122–2127.

5. Lee SJ, Ahn IM. Effectiveness of percutaneous ethanol injection therapy in benign nodular and cystic thyroid diseases: long-term follow-up experience. Endocr J 2005; 52: 455–462.

6. Halenka M, Karasek D, Schovanek J, Frysak Z. Safe and effective percutaneous ethanol injection therapy of 200 thyroid cyst. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019 Mar 29. doi: 10.5507/bp.2019.007. [Epub ahead of print].

7. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016; 26: 1–133.

8. Wartofsky L. The thyroid nodule. In: Wartofsky L (ed). Thyroid Cancer: A Comprehensive Guide to Clinical Management. Totowa, NJ: Humana Press, 2000: 3–7.

9. Bargren A, Meyer-Rochow G, Sywak M, et al. Diagnostic utility of fine-needle aspiration cytology in pediatric differentiated thyroid cancer. World J Surg 2010; 34: 1254-1260.

10. Treece GL, Georgitis WJ, Hofeldt FD. Resolution of recurrent thyroid cysts with tetracycline instillation. Arch Intern Med 1983; 143: 2285–2287.

11. Rozman B, Bence-Zigman Z, Tomic-Brzac H, et al. Sclerosation of thyroid cysts by ethanol. Periodicum Biologorum 1989; 91: 1116–1118.

12. Gonsorcíková V, Trejbal D, Tajtáková M, et al. Treatment of autonomous thyroid gland nodules using percutaneous injections of ethanol under ultrasonography control--initial experience. Vnitř Lék 1996; 42: 166–170.

13. Gharib H, Papini E, Paschke R, et al. AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and EuropeanThyroid Association Medical Guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract 2010; 16 (Suppl 1): 1–43.

14. Cho YS, Lee HK, Ahn IM, et al. Sonographically guided ethanol sclerotherapy for benign thyroid cysts: results in 22 patients. AJR Am J Roentgenol 2000; 174: 213–216.

15. Sung JY, Baek JH, Kim YS, et al. One-step ethanol ablation of viscous cystic thyroid nodules. AJR Am J Roentgenol 2008; 191: 1730–1733

16. Raggiunti B, Fiore G, Mongia A, et al. A 7-year follow-up of patients with thyroid cysts and pseudocysts treated with percutaneous ethanol injection: volume change and cost analysis. J Ultrasound 2009; 12: 107–111.

17. Reverter JL, Alonso N, Avila M, et al. 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.

18. Kim YJ, Baek JH, Ha EJ, et al. Cystic versus predominantly cystic thyroid nodules: efficacy of ethanol ablation and analysis of related factors. Eur Radiol 2012; 22: 1573–1578.

19. Verde G, Papini E, Pacella CM, et al. Ultrasound guided percutaneous ethanol injection in the treatment of cystic thyroid nodules. Clin Endocrinol (Oxf) 1994; 41: 719–724.

20. 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: 971–974.