Endocrine Abstracts

Introduction: Surgery is the usual therapeutic approach for treatment of recurrent lymph node metastases due to thyroid carcinoma. However, there is no evidence of improvement in the final prognosis and is not an option without risk, especially in patients such as those who already underwent several surgeries or suffered from comorbidities.

PEI is a useful alternative for treatment of selected thyroid diseases. Here, we present our experience in patients with recurrent lymph node metastases.

Patients and methods: Patients: 24 recurrent metastatic lymphadenophaties in 8 patients, previously diagnosed of thyroid carcinoma with high risk of surgical complications. Histology: 4 medullary and 4 differentiated thyroid carcinomas.

Methods: Ethanol (0.4–1 mL) was infused inside adenopathies under ultrasonographic control. Maximum diameter and vascularisation pattern of each adenopathy, serum thyroglobulin (TG) and calcitonin (CT) were measured previously and 3 months after the injection. Time of follow-up was 3 to 31 months. Persistence of vascularisation as well as positivity of biochemical markers were criteria for repeat PEI. We defined as success criteria: adenopathy disappearence or decreased in size with absence of vascularisation and decreament of CT or TG levels.

Results: Sixteen out of 24 adenopathies disappeared or decreased in size with absence of vascularisation (two embolizations were needed in four cases).

In the rest: Six out of 8 decreased in size and are waiting for a new PEI; the other two adenopathies were in the same patient, who developed distant metastases and died before receiving any other treatment.

TG values decreased in all patients (from 82 to 100% compared with its initial value), whereas serum CT showed no change in 2 patients and decreased in the other two.

Conclusion: PEI could be considered as a useful therapeutic tool for treatment of metastatic lymphadenophaties in selected cases.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector