Treatment of thyroid hot nodules by percutaneous ethanol injection

ABSTRACT

Twenty-eight patients with autonomously functioning thyroid nodules of 2-6 cm diameter were selected. Fifteen patients were clinically and biochemically hyperthyroid. Depending on the nodule size, 2-4 ml of 95% ethanol was injected into the nodules. There were no major complications. Thyroid scans were done at two-month intervals and repeated injections were done only if the hot nodules were still present. 71.4% needed only one, 25% needed two, and 3.6% needed three injections for complete ablation of the hot nodules. On follow-up examination all nodules had shrunken in size and those patients with hyperthyroidism showed improvement of their symptoms. The hormone levels also returned to normal range.Repeated thyroid scans showed disappearance of the hot nodule and gradual resumption of function of the previously suppressed thyroid tissue. This study shows that percutaneous ethanol injection is a safe and cheap alternative to surgical and radioiodine ablation of AFTN's and this can be achieved in most cases in one or two sessions. Importantly, with this method, the chance of future hypothyroidism will be nil