RESUMEN
This study was designed to clarify the efficacy of combination of thyroid hormone (euthyrox) therapy and percutaneous ethanol injection (PEI) in benign nodular thyroid diseases. 55 patients with benign nodular goiter after the first PEI session during the whole study period (from 3 till 12 months after PEI) daily received euthyrox in a dosage - 50 mkg. 48 women and 7 men with thyroid nodules of the various sizes, structures and echogenecity have been included in the study group. The control group consisted of 32 patients: 29 women and 3 men in the same age range as in the study group. In both groups PEI procedure was performed but in the control group no thyroid hormone was added. In patients who were receiving 50 mkg daily after 3 months of PEI progressive reduction of the nodule sizes was registered, the volume of a thyroid gland has decreased and approached to normal parameters (15,79+/-1,21 ml), and in 6-2 months the normal volume of the thyroid gland was registered. Thus, combination of thyroid hormone therapy and percutaneous ethanol injection (PEI) in treatment of patients with benign nodular goiter normalizes the size of a thyroid gland. Euthyrox is the additional factor causing reduction of thyroid nodules and constraining occurrence of new nodules in a thyroid gland.
Asunto(s)
Etanol/uso terapéutico , Bocio Nodular/tratamiento farmacológico , Tiroxina/uso terapéutico , Quimioterapia Combinada , Femenino , Humanos , Inyecciones Subcutáneas , Masculino , Resultado del TratamientoRESUMEN
The aim of this study was to evaluate whether percutaneous ethanol injection (PEI) outcome might be depends on the morphological structure of cold colloid thyroid nodule. Some pathologists apply terms such as colloid or adenomatous nodules to lesions which are more or less localized with areas of apparently normal or altered architecture. PEI was performed in 34 patients (9 men and 25 women, who had a mean age of 41 years, with a range of 18-76) with normal thyroid function and a solid benign thyroid nodule. All patients had fine needle aspirations (FNAs) which resulted in a diagnosis of the presence of a colloid nodule and ruled out malignancy of the nodule. Patients who were treated with PEI were classified into two groups according to the structure of the colloid nodule: group A included 20 patients with colloid and group B - 14 patients with adenomatous nodules. The mean thyroid nodule volume in group A was 5,3 mL and in group B - 8,8 mL, respectively. Patients underwent 1-6 PEI sessions. A needle was positioned in the thyroid nodule with US guidance. Thyroid nodule volume was evaluated before and 3, 6 and 12 months after treatment. In the group A the mean thyroid nodule volume decreased from 5,3 mL to 1,9 mL (64%) and in the group B - from 8,8 mL to 2,5 mL (71) after 12 months. Differences in volume reductions were statistically significant (p<0,026). The treatment was well-tolerated in all patients. These results suggest that more significant effect was reached in group B (patients with adenomatous nodules) and therefore the outcome of the PEI depends on the morphological structure of cold colloid nodule.
Asunto(s)
Etanol/uso terapéutico , Neoplasias de la Tiroides/tratamiento farmacológico , Administración Cutánea , Adolescente , Adulto , Anciano , Etanol/administración & dosificación , Femenino , Humanos , Inyecciones , Masculino , Persona de Mediana Edad , Nódulo TiroideoRESUMEN
This study was designed to clarify the long-term efficacy of percutaneous ethanol injection (PEI) therapy in benign nodular and cystic thyroid diseases. Solid nodule and complex cyst were classified into three groups in accordance with volume reduction. In solid nodule (n = 38) and complex cyst (n=8), initial volume was significantly reduced to final volumes, and volume reduction persisted during follow-up period. Complete response, partial response and no response were as follows: 21 %, 63 %, 15 % in solid nodule; 37,5 %, 50 %, 12,5 % in complex cyst, respectively. Differences of volume reduction according to initial volume (>10 mL vs <10 mL) were significant. Correlation between initial and final volumes, and between initial volume and volume reduction were also significant. Complications were developed in 10,5 % of patients but there were not permanent complications. In conclusion, our data suggest that PEI therapy could be an effective and safe therapeutic modality for benign nodular and cystic thyroid diseases especially when initial volume is more than 10 mL.