Percutaneous ethanol sclerotherapy of autonomous thyroid nodules: preliminary results

Percutaneous ethanol sclerotherapy was applied to 20 patients (17 women and 3 men, aged 30 to 77 yrs) with autonomous thyroid nodules. The patients either were contraindicated because of hazardous concomitant diseases or refused surgical or 131I treatment. Ethanol (95 alc%) was injected in 4 to 6 sessions at a mean dose of 0.63 ml/cc nodular tissue. Physical examination, T3, T4 and TSH assays, thyroid scintigraphy, sonography, and fine needle aspiration biopsy were used to evaluate the treatment results within a 12-month follow-up. Two months after ethanol injection all patients showed an improvement; in six patients the symptoms recurred in the 6th month. Two of them underwent a second cycle of ethanol injection. 12 months later an euthyroid state was maintained in 16 (80%) patients, while 4 (20%) did not respond to the treatment. The treatment results were markedly determined by the nodule size as no effect was achieved in nodules larger than 15-20 ml in volume. This method appears to be an appropriate and harmless alternative to the surgical and 131I treatment of autonomous thyroid nodules less than 15-20 ml in volume, especially in patients with grave concomitant diseases.