Endocrine Abstracts

Aim: Percutenous ethanol injection (PEI) is a minimally invasive method which can be preferred in treatment of cystic thyroid nodules. We have presented our cases of PEI below.

Material and methods: We have performed PEI to 8 patients in our clinic. We have made ultrasound guided fluid aspiration from the cysts which were confirmed to be benign. We have injected ethanol (98%) into the pouche of the cyst in an amount that is 20–40% of the cystic fluid volume with ultrasound guidance.

Results: The mean volume of cystic nodules was 13.6 ml (3.8–36.7 ml) and mean ethanol volume injected was 6.5 ml (1.5–15 ml). After the first performance of PEI, we have recorded 50% reduction in nodule sizes at the first control visit of 2 patients. We had to perform PEI for the second time because we couldn’t record any significant reduction in nodule size in 6 patients. During the second PEI performance, mean nodule volume was 10.7 ml (6.5–32.4 ml) where as mean ethanol volume used was 4.5 ml (3–15 ml). After the second PEI, we observed almost 50% reduction in thyroid nodule sizes of extra 4 patients. In two patients, we could not record any effective size reduction even after the 2nd PEI. They were referred to a surgeon for thyroidectomy. At the control visit, made 6 months after PEI, in 4 of 6 patients the cystic component of the nodules completely disappeared. Mean nodule size of these 6 patients was calculated as 0.36 ml (0.25–0.54 ml). One year after PEI, we made fine needle aspiration to the nodules previously received ethanol injection and the cytology results were all benign.

Discussion: PEI may be an alternative to surgery in complex nodules which are dominantly cystic in nature after eliminating the malignancy probability with fine needle aspiration.