Percutaneous Ethanol Ablation for Management of Cystic Thyroid Nodules: A Case Report
Introduction: Percutaneous Ethanol Ablation (PEA) has been recommended as the first-line treatment option for symptomatic benign cystic or predominantly cystic thyroid nodules, and it has been shown to be more effective and safer than other techniques in previous studies. Here, we present a case of a 44-year-old man with thyroid nodules who underwent PEA.
Case Presentation: We report the case of a 44-year-old man with a painless mass that is getting bigger on his right neck. The physical examination measured 3.0 × 3.0 × 3.0 cm, mobile on swallowing, no pain on palpation. Thyroid function tests show a euthyroid state (TSH 2.4 mIU/L, FT4 1.2 ng/dL). The ultrasound examination in January 2020 showed a colloid cyst on the right thyroid, measured 3.03 × 2.82 × 3.56 cm (TIRADS 1). Cytological examination showed the results of non-infectious cystic fluid. The patient underwent US-guided PEA using 7 ml of ethanol by the moving-shot technique. The procedure was well tolerated by the patient and no adverse events were noted. A week after the procedure, there was a visible and progressive reduction of the nodule with no complaint from the patient. A month after the procedure, the patient came back with no recurrences, complaints, or other complications.
Conclusions: PEA for thyroid lesions is an effective and safe method. PEA should be the first option for the treatment of pure cystic and predominantly cystic nodules. PEA is a safe procedure that is easy to repeat and to be performed on an outpatient basis.
Lang BH, Wu ALH. The efficacy and safety of high-intensity focused ultrasound ablation of benign thyroid nodules. Ultrasonography. 2018;37(2):89–97.
Basu N, Dutta D, Maisnam I, Basu S, Ghosh S, Chowdhury S, et al. Percutaneous ethanol ablation in managing predominantly cystic thyroid nodules: An eastern India perspective. Indian J Endocrinol Metab. 2014;18(5):662–8.
Dobrinja C, Bernardi S, Fabris B, Eramo R, Makovac P, Bazzocchi G, et al. Surgical and Pathological Changes after Radiofrequency Ablation of Thyroid Nodules. 2015;2015.
Samy AK, Ridgway D, Orabi A, Suppiah A. Minimally invasive, video-assisted thyroidectomy: First experience from the United Kingdom. Ann R Coll Surg Engl. 2010;92(5):379–84.
Reverter JL, Alonso N, Avila M, Lucas A, Mauricio D, Puig-Domingo M. 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(1):1–6.
Baek JH, Ha EJ, Choi YJ, Sung JY, Kim JK, Shong YK. Radiofrequency versus ethanol ablation for treating predominantly cystic thyroid nodules: A randomized clinical trial. Korean J Radiol. 2015;16(6):1332–40.
Park HS, Yim Y, Baek JH, Choi YJ, Shong YK, Lee JH. Ethanol ablation as a treatment strategy for benign cystic thyroid nodules: a comparison of the ethanol retention and aspiration techniques. Ultrasonography. 2019;38(2):166–71.
Hahn SY, Shin JH, Na DG, Ha EJ, Ahn HS, Lim HK, et al. Ethanol ablation of the thyroid nodules: 2018 consensus statement by the Korean society of thyroid radiology. Korean J Radiol. 2019;20(4):609–20.
Felício JS, Conceição AMS, Santos FM, Sato MMM, Bastos F de A, Braga de Souza ACC, et al. Ultrasound-Guided Percutaneous Ethanol Injection Protocol to Treat Solid and Mixed Thyroid Nodules. Front Endocrinol (Lausanne). 2016;7(June):1–6.
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, 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.
Kim YJ, Baek JH, Ha EJ, Lim HK, Lee JH, Sung JY, et al. Cystic versus predominantly cystic thyroid nodules: Efficacy of ethanol ablation and analysis of related factors. Eur Radiol. 2012;22(7):1573–8.
Papini E, Gugliemi R, Pacella CM. Laser, radiofrequency, and ethanol ablation for the management of thyroid nodules. Curr Opin Endocrinol Diabetes Obes. 2016;23(5):400–6.
Bennedbæk FN, Hegedüs L. Treatment of Recurrent Thyroid Cysts with Ethanol: A Randomized Double-Blind Controlled Trial. J Clin Endocrinol Metab. 2003;88(12):5773–7.
Papini E, Pacella CM, Hegedus L. Diagnosis of endocrine disease: Thyroid ultrasound (US) and US-assisted procedures: From the shadows into an array of applications. Eur J Endocrinol. 2014;170(4):133–46.
Article MetricsAbstract view : 38 times
PDF - 23 times
- There are currently no refbacks.
Copyright (c) 2020 Indonesian Journal of Cancer
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.