Abstract

Introduction: Thyroid nodules are among the most common endocrine complaints in the United States. With increasing incidence of differentiated thyroid carcinoma there has been a widespread interest in development of minimally invasive treatments such as percutaneous ethanol injection (PEI) to manage thyroid pathology. In our review of published literatures, we discuss the application of ethanol injection for treatment of benign thyroid nodules and its efficacy in treating locally recurrent papillary thyroid carcinoma.
Evolving treatment roles of PEI: PEI has been most successful at treating recurrent cystic nodules. In hyperfunctioning nodules, PEI is indicated for patients who are poor surgical and radioiodine therapy candidates. Initial trials of PEI in metastatic lymph nodes in papillary thyroid carcinoma have yielded promising therapeutic results with only minor side effects. PEI does not remove the option of future radio-frequency ablation or surgery which may become necessary in some cases.
Conclusion: In our opinion, percutaneous ethanol injection proves to be a superior treatment modality for benign thyroid nodules showing markedly higher success in cystic nodules. Its safety and efficacy in treating recurrent papillary thyroid carcinoma is significant.

Keywords: Thyroid nodules, Recurrent thyroid carcinoma, Lymph node metastasis, Re-operation, Ethanol ablation