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Percutaneous Ethanol Injection (PEI) for Thyroid Cysts and Other Neck Lesions

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Thyroid and Parathyroid Ultrasound and Ultrasound-Guided FNA

Abstract

Percutaneous ethanol injection (PEI), also known as ethanol, or alcohol, ablation, is the first-line treatment for thyroid cystic nodules. Immediately after its instillation into the thyroid tissue, ethanol causes coagulative necrosis and fibrotic changes resulting in a stable and durable regression of the treated cystic lesion. Long-term effectiveness of PEI, along with its substantial safety, has been consistently documented by many studies published in the last decades: therefore this procedure has gained a worldwide diffusion. In parallel with the successful utilization of the sclerosing properties of ethanol in thyroid cystic nodules, PEI application for treatment of autonomously functioning thyroid nodules (AFTNs) or solid cold thyroid nodules has been progressively abandoned due to its poor efficacy, the not negligible risk of side effects, and the expanding use of other ultrasound-guided interventional techniques, namely, laser thermal ablation (LTA) and radio-frequency ablation (RFA). Ethanol ablation has also been used with good results for treating hyperplastic parathyroid (PT) glands in patients with chronic renal failure as well as large nonfunctioning PT cysts. In addition, in selected patients, metastatic lymph nodes from differentiated thyroid cancer can be treated with PEI as an alternative option to surgery.

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Authors and Affiliations

  1. Endocrinology Unit, Medical Specialities Department, Arcispedale S. Maria Nuova – IRCCS, Reggio Emilia, Italy

    Andrea Frasoldati MD, PhD

  2. Endocrinology Unit, Centro Palmer, Reggio Emilia, Italy

    Petros Tsamatropoulos MD

  3. University of Arizona College of Medicine, Phoenix, AZ, USA

    Daniel S. Duick MD, MACE

  4. Endocrinology Associates, PA, Scottsdale, AZ, USA

    Daniel S. Duick MD, MACE

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  1. Andrea Frasoldati MD, PhD
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  2. Petros Tsamatropoulos MD
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  3. Daniel S. Duick MD, MACE
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Correspondence to Andrea Frasoldati MD, PhD .

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Editors and Affiliations

  1. University of Arizona, College of Medicine, Phoenix, AZ, USA

    Daniel S. Duick

  2. Geisel School of Medicine at Dartmouth, Thyroid Center of New Hampshire, St. Joseph Hospital, Nashua, NH, USA

    Robert A. Levine

  3. Florida State University, College of Medicine, Tallahassee, FL, USA

    Mark A. Lupo

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Frasoldati, A., Tsamatropoulos, P., Duick, D.S. (2018). Percutaneous Ethanol Injection (PEI) for Thyroid Cysts and Other Neck Lesions. In: Duick, D., Levine, R., Lupo, M. (eds) Thyroid and Parathyroid Ultrasound and Ultrasound-Guided FNA . Springer, Cham. https://doi.org/10.1007/978-3-319-67238-0_14

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  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-67237-3

  • Online ISBN: 978-3-319-67238-0

  • eBook Packages: MedicineMedicine (R0)

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