Percutaneous Ethanol Injection Therapy for Locally Recurrent Papillary Thyroid Carcinoma

Lim, Chi Young; Lee, Jandee; Nam, Kee Hyun; Chang, Hang Seok; Chung, Woong Youn; Kim, Eun kyoung; Yang, Woo Ick; Park, Cheong Soo

Abstract

PURPOSE: Percutaneous ethanol injection therapy (PEIT) has been infrequently tried to treat hepatic tumors, thyroid tumors, and primary and secondary hyperparathyroidism. We adopted this technique for treating locally recurrent papillary thyroid carcinomas. The objective of this study is to evaluate the local therapeutic efficacy, side effects and complications of the PEIT for treating locally recurrent papillary thyroid carcinomas. MATHODS: From October 2002 to September 2005, 16 papillary thyroid carcinoma patients (3 males and 13 females) with 24 histologically proven locally recurrent lesions underwent sonography-guided PEIT under local anesthesia when reoperation or other treatments were refused or contraindicated. Of the 24 nodules in 16 patients, 8 recurred in the thyroid bed, 13 recurred in the lateral neck nodes, and 3 recurred in the central neck nodes. Ethanol was injected every 3 months under sonographic guidance. The median follow-up period was 18 months (range: 7~37 months).
RESULTS
All the patients tolerated the procedures well with only mild local pain. There were no major complications. Only one patient suffered from a transient vocal cord palsy. A significant decrease of tumor size was observed in all the lesions. The pre-injection diameter of the lesions ranged 5.5 to 25.0 mm (median: 9.9 mm), and this was decreased to 0 to 17 mm (median: 5.3 mm) after PEIT. Of the 4 lesions in 4 patients, the recurrent lesions disappeared completely.
CONCLUSION
Our experiences suggest that PEIT appears to be an effective alternative option for treating recurrent lesions of thyroid carcinomas in the properly selected patients. A large prospective study with long-term follow-up is necessary to determine if PEIT has an impact on survival and recurrences.