Endocrine Abstracts

Introduction and objectives: Multiple surgeries are associated with many complications in the local recurrence of papillary thyroid carcinoma. Our objective is to evaluate the efficiency of the enolization in the recurrent metastatic cervical lymph nodes in patients with limited nodal disease.

Material and methods: We studied 13 patients (six males and seven females) with a mean age of 43±14.4 years with papillary thyroid carcinoma intervened (total thyroidectomy). In our follow-up, they present nodal recurrence (23 lymph nodes). Seven had previous lymphadenectomy (1–3) and they had received a mean I-131 dose of 238.46±71.25 mCi. In four cases, the anti-Tg Ab were elevated where the PET was positive. All of them showed pathological levels of Tg-FNAB (1.7–15 342 ng/ml). Guided by ultrasound, we injected absolute ethanol (20–30% of total lymph node). Were required for 1–3 enolizations spaced in 3–4 months until the absence of vascular flow.

Results: The mean nodal volume was 0.155±0.071 cm³. The initial mean thyroglobulin ON was 5.70±5.08 ng/ml. We observed a nodal volume reduction with no vascular flow in all cases with an average volume of 0.075±0.054 cm³ postenolization (−0080 cm³, P<0.0001). We got a reduction> 30% in 18 lymph nodes, >50% in 13, >70% in nine and disappearance in six. We also observed a decrease in average thyroglobulin levels to 3.47±4.17 ng/ml (−2.23±1.90, P<0.01). In six of nine patients, the reduction in the levels of thyroglobulin was >50%. All without evaluate the cases with Tg Ab positive. No significant adverse reactions were observed.

Conclusions: The ultrasound-guided enolization is presented as an excellent alternative to surgery for local recurrence of thyroid papillary carcinoma in selected cases where surgery is not recommended.