[Alcohol sclerotherapy for benign solitary thyroid nodules]

The introduction of new diagnostic methods for the evaluation of solitary thyroid nodules allows for unquestionable differentiation between malignant and benign lesions in most cases. It makes therapeutic procedure other than surgical therapy possible. One of the procedures is the percutaneous alcohol sclerotherapy (PSA). It is the most commonly used for the treatment of thyroid cysts and autonomous thyroid nodules. PSA was first proposed by Livraghi in 1990 as possible therapy for autonomously functioning thyroid nodules. This method is based on the administration of a limited amount of sterile alcohol into the thyroid nodule under direct ultrasonografic control. The application of PSA according to the worked out procedure gives a permanent remission of thyroid cysts in most cases and the 85-100% decrease of thyroid nodule volume. In the case of "toxic" and "pretoxic" type of nodules, a normalization of serum FT3, FT4 and TSH level occurs. Scintigraphy shows recovery of extranodular uptake of radionuclide and effacement of previously hot area of thyroid scintiscan. The following complications were observed after PSA: pain of the injection site, local hematoma, fever, sinus tachycardia, transient dysphonia. The intensity of these complications is generally low.