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Ethanol ablation for giant thyroid cysts and parathyroid adenomas as an alternative to surgery in the elderly


Authors: M. Halenka
Authors place of work: III. interní klinika – nefrologická, revmatologická a endokrinologická, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice Olomouc
Published in the journal: Geriatrie a Gerontologie 2023, 12, č. 4: 186-192
Category:

Summary

Older adults can encounter a large nodular goiter with cysts causing mechanical complications. Another finding may be primary hyperparathyroidism with hypercalcemia. Both situations are usually treated surgically. For the senior population at increased surgical risk, ethanol ablation under ultrasonographic control can be performed as an alternative in selected situations. We present four cases of successful ethanol ablation in patients older than 80 years who no longer required surgery. In two patients with 240 ml and 170 ml huge thyroid cysts, we achieved volume reduction was 99.5 and 99 %, respectively. In two patients with large solitary parathyroid adenomas with severe hypercalcemia, the volume of large adenomas was reduced by 2.1 ml and 2.5 ml (91.5 % and 76 %) and a decrease in serum calcium from 3.1 mmol/l and 2.85 mmol/l to norm.


Zdroje

1.     McHenry CR, Slusarczyk SJ, Khiyami A. Recommendations for management of cystic thyroid disease. Surgery 1999; 126: 1167–1171.

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.     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): 1–133.

4.     Durante C, Grani G, Lamartina L, et al. The diagnosis and management of thyroid nodules: a review. JAMA 2018; 319: 914–924.

5.     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.

6.     Yasuda K, Ozaki O, Sugino K, et al. Treatment of cystic lesions of the thyroid by ethanol instillation. World J Surg 1992; 16: 958–961.

7.     Zingrillo M, Torlontano M, Ghiggi MR, et al. Percutaneous ethanol injection of large thyroid cystic nodules. Thyroid 1996; 6: 403–408.

8.     Broulík P, Adámek S, Libánský P, et al. Diagnosis and treatment of primary hyperparathyroidism. Interní Med 2007; 3: 130–132.

9.     Bilezikian JP, Khan AA, Potts JT Jr. Third International Workshop on the Management of Asymptomatic Primary Hyperthyroidism. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the third international workshop. J Clin Endocrinol Metab 2009; 94: 335–339.

10.     Doporučený postup interního předoperačního vyšetření před elektivními operačními výkony. https://www.ipvz.cz/vzdelavaci-akce/dokumenty/11088-2017-2018-doporuceny-postup-interniho-predoperacniho-vysetreni-mz.pdf.

11.     Halenka M, Fryšák Z. Atlas ultrasonografie štítné žlázy. 2. vyd. Praha: Maxdorf 2017: 331–344. 

12.     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(8): 2122–2127.

13.     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(4): 455–462.

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

15.     Del Prete S, Caraglia M, Russo D, et al. Percutaneous ethanol injection efficacy in the treatment of large symptomatic thyroid cystic nodules: ten-year follow-up of a large series. Thyroid 2002; 12(9): 815–821.

16.     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(1): 213–216.

17.     Sung JY, Baek JH, Kim YS, et al. One-step ethanol ablation of viscous cystic thyroid nodules. AJR Am J Roentgenol 2008; 191(6): 1730–1733.

18.     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 European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract 2010; 16: 1–43.

19.     Hahn SY, Shin JH, Na DG, et al. Korean Society of Thyroid Radiology (KSThR); Korean Society of Radiology. Ethanol Ablation of the Thyroid Nodules: 2018 Consensus Statement by the Korean Society of Thyroid Radiology. Korean J Radiol 2019; 20(4): 609–620.

20.     Solbiati L, Giangrande A, De Pra L, et al. Percutaneous ethanol injection of parathyroid tumors under US guidance: treatment for secondary hyperparathyroidism. Radiology 1985; 155: 607–610.

21.    Müller-Gärtner HW, Beil FU, Schneider C, et al. Percutaneous transthyroidal instillation treatment of parathyroid adenoma with ethanol in primary hyperparathyroidism. Dtsch Med Wochenschr 1987; 112: 1459–1461.

22.    Charboneau JW, Hay ID, van Heerden JA. Persistent primary hyperparathyroidism: successful ultrasound-guided percutaneous ethanol ablation of an occult adenoma. Mayo Clin Proc 1988; 63: 913–917.

23.     Karstrup S, Transbøl I, Holm HH, et al. Ultrasound-guided chemical parathyroidectomy in patients with primary hyperparathyroidism: a prospective study. Br J Radiol 1989; 62: 1037–1042.

24.     Harman CR, Grant CS, Hay ID, et al. Indications, technique, and efficacy of alcohol injection of enlarged parathyroid glands in patients with primary hyperparathyroidism. Surgery 1998; 124: 1011–1019.

25.     Stratigis S, Stylianou K, Mamalaki E, et al. Percutaneous ethanol injection therapy: a surgery-sparing treatment for primary hyperparathyroidism. Clin Endocrinol (Oxf) 2008; 69: 542–548.

26.     Cercueil JP, Jacob D, Verges B, et al. Percutaneous ethanol injection into parathyroid adenomas: mid- and long-term results. Eur Radiol 1998; 8: 1565–1569.

27.     van Heerden JA, Grant CS. Surgical treatment of primary hyperparathyroidism: an institutional perspective. World J Surg 1991; 15: 688–692.

28.     Udelsman R. Six hundred fifty-six consecutive explorations for primary hyperparathyroidism. Ann Surg 2002; 235: 665–670.

29.     Fukagawa M, Kitaoka M, Tominaga Y, et al. Japanese Society for Parathyroid Intervention. Guidelines for percutaneous ethanol injection therapy of the parathyroid glands in chronic dialysis patients. Nephrol Dial Transplant 2003; 18(Suppl 3): iii31–3.

30. Halenka M, Fryšák Z, Karásek D, et al. Úspěšná sklerotizace adenomu příštítného tělíska absolutním alkoholem u devadesátiletého seniora. Interní Med 2016; 18(3): 146–149.

Štítky
Geriatrics General practitioner for adults Orthopaedic prosthetics
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