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A Rare Complication following Thyroid Percutaneous Ethanol Injection: Plummer Adenoma
Roberto Cesareo1, Anda Mihaela Naciu2, Valerio Pasqualini3
1Department of Internal Medicine, "S. M. Goretti" Hospital, Latina, Italy.
Case Reports in Endocrinology
|May 4, 2017
Summary
Percutaneous ethanol injection (PEI) effectively treated a benign thyroid nodule, leading to significant symptom relief. However, this case highlights a rare complication: the development of Plummer adenoma post-PEI.
Area of Science:
- Endocrinology
- Minimally Invasive Procedures
- Thyroidology
Background:
- Percutaneous ethanol injection (PEI) is a minimally invasive outpatient treatment for benign thyroid nodules.
- While generally safe, rare severe complications like jugular vein thrombosis and laryngeal necrosis have been reported.
- Thyrotoxicosis after PEI is uncommon, with only four cases linked to Graves' disease previously documented.
Observation:
- A 58-year-old female with a large, benign left thyroid cystic nodule, who refused surgery, underwent PEI.
- The procedure successfully reduced nodule volume and alleviated compressive symptoms.
- Approximately 30 days post-PEI, the patient developed symptomatic thyrotoxicosis.
Findings:
- Thyroid function tests and scintigraphy ruled out other hyperthyroidism causes.
- The diagnosis of Plummer adenoma was established in the context of post-PEI thyrotoxicosis.
- This represents the first reported instance of Plummer adenoma developing after PEI for a nontoxic thyroid nodule.
Implications:
- PEI can induce thyrotoxicosis through the development of Plummer adenoma, a previously unreported complication.
- Clinicians should consider monitoring for Plummer adenoma in patients developing thyrotoxicosis after PEI.
- This finding expands the spectrum of potential complications associated with PEI for benign thyroid conditions.
