| Swider and Grzywa, Rzcszów, Poland, evaluated the effect of percutaneous ethanol injection (PEI) in group A: 17 patients with a benign solid thyroid nodule, mean volume 17.3 ml, and group B: 19 patients with benign nodules that were predominantly cystic, mean volume 24.9 ml. Patients from group A received a mean of 5 injections and group B of 2 injections. After 12, 36, 48 months mean nodule decrease in group A was 68%, 73%, and 85% respectively. These values were for group B 89%, 94%, and 94% respectively. No serious complications were observed and the authors conclude that PEI is an efficacious and safe method in the treatment of non-autonomous thyroid nodules. Monzani et al., Pisa, Italy, reported their results of 10 years experience with PEI in 247 patients; 140 with autonomous thyroid adenoma (89 toxic and 51 pre-toxic) and 107 with a benign cold nodule. The mean number of injections was 5 and although PEI was well tolerated, transient local pain was present in 30% of sessions. Transient vocal cord palsy occurred in 6 patients and in 10% of sessions in patients with toxic nodules a transient temperature increase to 38 °C occurred. A positive functional effect in hyperthyroid nodules was seen in 81% and in 92% in "pretoxic" autonomous nodules. The authors suggest that PEI could be considered as a first choice of treatment in the case for thyroid cysts and is certainly suitable for benign cold solid nodules. It may also be the first choice for "pretoxic" nodules and is very effective in toxic nodules when <3 cm in diameter. (Comment: It would be nice to know if the number of clinics that select PEI as a first choice of treatment for benign thyroid nodules is increasing). |
