Ethanol instillation of adenoma of the thyroid gland — a five-year experience

Abstract

SummaryIn a prospective study, 103 patients were treated with percutaneous ethanol injection (PEI). The study group consisted of 70 women and 33 men, with an average age of 64.5 years and an age-range of 31–92 years. 64 patients had a heterogeneous goitre with a struma multinodosa. 60 patients were suffering from toxic adenomas and 43 from pretoxic adenomas. 60 had a solitary adenoma and 33 had ≥ 2 autonomous areas. Multi-focal autonomy was present in 10 patients. The nodule volume was 1–91 ml, with an average of 10 ml. Colour Doppler sonography was able to differentiate uni-focal and oligo-focal tissue with hyperfunction from other nodules in 60 out of 64 patients. This had not been possible with any of these patients using B-image sonography. The increased vascularisation of the nodules correlated with the greater activity stimulation in the scintigram. During the course of PEI, colour-Doppler sonography was able to document a reduction of vascularisation in the adenomas of all patients. The number of sessions was 1–8 for each patient, with an average of four, using an average injection of 0.5 ml 96% alcohol per ml of nodule volume at each session. The observation period was 1–60 months (average of 12.8 months). In 50% of the patients with toxic adenomas, complete success was achieved, with elimination of the autonomous area and an increase in the thyroid stimulating hormone (TSH) basal levels. At least partial success was achieved in 88%, and euthyroidism was produced without further thyrostatic medication. Complete success was achieved in 70% of the cases of pretoxic adenoma. The final success of the therapy was dependent on the initial size and number of the adenomas. An average reduction of 47% in adenoma size was achieved at the conclusion of the therapy.