Percutaneous ethanol injections in the treatment of nodular thyroid disease--fourteen years of experience

Surgery, radioactive iodine, and suppressive doses of Lthyroxine are commonly used in the treatment of benign nodular thyroid disease, with the best results achieved with surgery. However, recent advances in cytological diagnostic methods enable patients to choose alternative therapies if there are some contraindications or there is no agreement for surgery. Over past 14 years percutaneous ethanol injections (PEI), used in the past as a therapy for liver, kidney, parathyroid and adrenal cortical tumors, have been developed as an alternative method in the management of thyroid nodules. This paper reviews the investigations of a number aspects of PEI in the treatment of thyroid nodules reported in the literature. The evidence demonstrate that PEI is effective in the case of both solid non-toxic and autonomously functioning toxic nodules as well as cystic nodules. In majority of cases restore normal serum fT4, fT3 and TSH concentrations and shrink the tumor volume. The method seems to be safe and generally well tolerated by the patients. However, the current research base on the efficacy and PEI-associated risks is still inadequate to determine definitively its role as a standard treatment of benign nodular thyroid disease. For example, there is no detailed data comparing the results of treatment with PEI to standard treatment with radioactive iodine and L-thyroxine. Despite it, we conclude that PEI is a valuable method that earned recognition among other methods of the thyroid nodules treatment.