scholarly journals Ultrasound-guided Percutaneous Ethanol Injection Therapy in a 92 Yearold Patient with Parathyroid Adenoma and with a History of Total Thyroidectomy for Papillary Thyroid Carcinoma

2016 ◽  
Vol 12 (3) ◽  
pp. 349-354
Author(s):  
M Halenka
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Parathyroid Adenoma ◽  
Percutaneous Ethanol Injection ◽  
Papillary Thyroid ◽  
Ultrasound Guided ◽  
Ethanol Injection ◽  
Percutaneous Ethanol Injection Therapy ◽  
History Of ◽  
Ethanol Injection Therapy

Percutaneous ethanol injection therapy in the treatment of thyroid and parathyroid diseases

1997 ◽  
Vol 136 (3) ◽  
pp. 240-250 ◽  
Author(s):  
Finn Noe Bennedbæk ◽  
Steen Karstrup ◽  
Laszlo Hegedüs
Keyword(s):  
Standard Therapy ◽  
Thyroid Nodules ◽  
Percutaneous Ethanol Injection ◽  
Ultrasound Guided ◽  
Ethanol Injection ◽  
Experimental Procedure ◽  
Percutaneous Ethanol Injection Therapy ◽  
Ethanol Injection Therapy ◽  
Parathyroid Tumours

Abstract Relevant English language articles published from 1966 to 1995 regarding ethanol therapy in the treatment of thyroid and parathyroid diseases were identified through a MEDLINE search and manual searches of identified articles. The sclerosing properties of ethanol have been recognized for many years and have offered interventional possibilities in the management of various benign as well as malignant lesions. The mechanism of action of ethanol appears to be related to a direct coagulative necrosis and local partial or complete small vessel thrombosis. Ultrasound-guided percutaneous ethanol injection therapy (PEIT) is rapid and performed on an out-patient basis and has now gained wide acceptance due to the accumulating evidence of the efficacy and safety of this therapeutic tool. Yet, there is a lack of prospective, randomized clinical trials comparing PEIT with 131I therapy or surgery with regard to its effects, especially long-term ones and it should therefore still be considered an experimental procedure. In benign endocrine diseases, PEIT has shown promising results in the treatment of autonomous thyroid nodules, benign solitary cold solid as well as cystic thyroid nodules and parathyroid tumours. Its use in pretoxic and toxic thyroid nodules has been evaluated in several uncontrolled studies, all demonstrating a high success rate in spite of the large number of treatments needed. So far efficacy and cost-effectiveness seem inferior to 131I and surgery. Short-term results of PEIT in benign cystic thyroid nodules are convincing with a high cure rate, but no controlled studies with long-term results are available. Preliminary results suggest that PEIT could become an alternative to surgical excision or levothyroxine therapy in the symptomatic solid cold benign thyroid nodule. Ultrasound-guided PEIT of parathyroid tumours has proven to be a useful method in highly selected patients in whom surgery has been found non-attractive and medical treatment ineffective. However, no prospective randomized trials have been published comparing the results of PEIT in parathyroid tumours with conventional surgical and medical treatments. PEIT has never been tested against standard therapy, but seems inferior to 131I and surgery. Side-effects caused by ethanol injection are generally few and transient and are related to the injection into solid nodules rather than cysts. Ethanol injection into solid profund nodules may seriously jeopardize subsequent surgery because of perinodular fibrosis. As an experimental procedure, not yet evaluated sufficiently, it should be reserved for patients who cannot or will not undergo standard therapy. Caution in routine use is advisable. European Journal of Endocrinology 136 240–250

Ultrasound-guided percutaneous ethanol injection therapy of neck cysts as an alternative to surgery

2021 ◽  
Vol 70 (3) ◽  
pp. 181-189
Author(s):  
Milan Halenka ◽  
Richard Salzmann ◽  
Hana Munteanu ◽  
Martin Brož ◽  
Jan Schovánek ◽  
...  
Keyword(s):  
Metastatic Lymph Node ◽  
Percutaneous Ethanol Injection ◽  
Volume Reduction ◽  
Injection Therapy ◽  
Surrounding Tissue ◽  
Ultrasound Guided ◽  
Ethanol Injection ◽  
Percutaneous Ethanol Injection Therapy ◽  
Ethanol Injection Therapy ◽  
Cervical Cysts

Summary Introduction: Some extrathyroidal cervical cystic lesions can be treated in selected situations by minimally invasive, low-risk method – ultrasound--guided percutaneous ethanol injection therapy (US-PEIT). Here we present 6 cases of neck cysts of various origins – ranula, thyroglossal duct cyst, branchial cleft cyst, midline neck cyst of the pyramidal lobe and dermoid cyst. Method and material: The cohort consisted of 6 patients (mean age 58 ± 13.3 years), who were followed for recurrent cervical cysts located outside the thyroid gland. The cysts were visible, palpable, aesthetically unpleasant and also mechanically compressing the surrounding tissue. After repeated evacuations, they filled in again. The patients repeatedly refused the recommended surgery and demanded an alternative solution. US-PEIT of thyroid cysts is used worldwide as a full-fledged alternative to surgical treatment. We used the same procedure for the treatment of presented neck cysts. Results: The initial volume of cysts was 2–35 mL (mean 17.7 mL); the patients underwent 1–6 sclerotization sessions (mean 3.6). The patients were followed for 12 months; the final volume of solid residue was 0.1–2 mL (mean 1 mL) representing volume reduction by 80–99% (mean 92%). Therapeutic success (volume reduction > 50%) was achieved in all patients. Conclusion: US-PEIT of cervical cysts as an alternative to surgery can be used especially in elderly patients with increased surgical risk or in patients refusing surgery. In middle-aged and older adults, the possibility of a necrotic metastatic lymph node should always be considered. Therefore, a benign cytological examination and an unsuspecting ultrasonographic and CT finding are the basic conditions before performing the ethanol ablation. Key words neck cysts – ultrasound-guided percutaneous ethanol injection therapy

scholarly journals Efficacy of Ultrasound-Guided Percutaneous Ethanol Injection Treatment in Patients with a Limited Number of Metastatic Cervical Lymph Nodes from Papillary Thyroid Carcinoma

2011 ◽  
Vol 96 (9) ◽  
pp. 2750-2755 ◽  
Author(s):  
Arne Heilo ◽  
Eva Sigstad ◽  
Kristin Holgersen Fagerlid ◽  
Olav Inge Håskjold ◽  
Krystyna Kotanska Grøholt ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Percutaneous Ethanol Injection ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Ethanol Injection ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph

Abstract Context: Repeated neck explorations can be a difficult task in patients with recurrent metastatic cervical lymph nodes from papillary thyroid carcinoma (PTC). Objective: The aim of this retrospective study has been to assess the efficacy of ultrasound (US)-guided percutaneous ethanol injection (PEI) as treatment of metastatic cervical lymph nodes from PTC. Materials and Methods: Sixty-nine patients who previously had undergone thyroidectomy for PTC were selected for inclusion. However, three patients were later excluded due to lack of follow-up. Lymph node status was determined by US-guided fine-needle aspiration biopsy and/or by raised levels of thyroglobulin in washouts from the cytological needle. Guided by US, 0.1–1.0 ml of 99.5% ethanol was injected into the metastatic lymph nodes. Results: Three patients (eight metastatic lymph nodes in total) were reassigned to surgery due to progression (multiple new metastases), leaving 63 patients and 109 neck lymph nodes to be included. Mean observation time was 38.4 months (range, 3–72). A total of 101 of the 109 (93%) metastatic lymph nodes responded to PEI treatment, 92 (84%) completely and nine incompletely. Two did not respond, and four progressed. Two lymph nodes previously considered successfully treated showed evidence of malignancy during follow-up. No significant side effects were reported. Conclusion: US-guided PEI treatment of metastatic lymph nodes seems to be an excellent alternative to surgery in patients with a limited number of neck metastases from PTC. This procedure should replace “berry picking” surgery.

Controlling recurrent papillary thyroid carcinoma in the neck by ultrasonography-guided percutaneous ethanol injection

2007 ◽  
Vol 18 (4) ◽  
pp. 835-842 ◽  
Author(s):  
Byung Moon Kim ◽  
Min Jung Kim ◽  
Eun-Kyung Kim ◽  
Sung Il Park ◽  
Cheong Soo Park ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Percutaneous Ethanol Injection ◽  
Papillary Thyroid ◽  
Ethanol Injection
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