Alcoolização de nódulo tiroidiano em região endêmica de bócio colóide / Alcoholization in the treatment of thyroid nodule in colloid goiter endemic region

A doença nodular tiroidiana é problema clínico comum, principalmente em regiões com carência de iodo. Esse estudo avaliou a eficácia da injeção percutânea de etanol (IPE) no tratamento de nódulos tiroidianos únicos, múltiplos, sólidos, císticos, de diferentes tamanhos com ou sem disfunção glandular, em região endêmica de bócio. Quarenta e dois pacientes com diagnóstico de bócio colóide ou hiperplasia nodular colóide, na punção biópsia aspirativa por agulha fina (PBAAF), foram selecionados para análise após terem sido submetidos a pelo menos duas IPEs. Os nódulos tiroidianos eram múltiplos (sólidos e ou císticos) em 52,4 por cento dos pacientes, únicos e sólidos ou mistos em 35,7 por cento e únicos e císticos em 11,9 por cento. A redução média dos nódulos após injeção de etanol foi de 58,2 por cento para os únicos e 60,8 por cento nos císticos. Nos nódulos múltiplos, avaliou-se a redução de todo o lobo tiroidiano, alcançando 52,4 por cento de redução. Os efeitos colaterais registrados foram decorrentes apenas do desconforto na aplicação. Este estudo indica que a injeção percutânea de etanol (IPE), alcançando reduções médias de volume que variam de 49 a 60 por cento, é método seguro, eficaz e simples para o tratamento de nódulos tiroidianos benignos.

Thyroid nodular disease is a common clinical disorder mainly in iodine lacking regions. This study has evaluated the effectiveness of percutaneous ethanol injection (PEI) in the treatment of single, multiple, solid, and cystic thyroid nodules of different sizes with or without glandular dysfunction, in goiter endemic region. Forty-two patients with diagnosis of colloid goiter or colloid nodular hyperplasia in fine-needle aspiration (FNA) were selected for analysis, after having been submitted to at least two PEI. Thyroid nodules were multiple (solid and or cystic) in 52.4 percent of the patients, single and solid or mixed in 35.7 percent, and single and cystic in 11.9 percent. The mean reduction of nodules after ethanol injection was of 58.2 percent in the single and of 60.8 percent in the cystic ones. The reduction of the whole thyroid lobe was evaluated in the multiple nodules and it reached 52.4 percent. The side-effects were registered only as a consequence of the application discomfort. This study points out that the percutaneous ethanol injection reaching volume mean reductions, varying from 49 percent to 60 percent, is a safe, effective, and simple method for the treatment of benign thyroid nodules.

Treatment of Simple Bone Cysts with Percutaneous Injection of Autogenous Bone Marrow with Crushed Cancellous Allograft / 대한정형외과학회잡지

PURPOSE: This study evaluated the feasibility and efficacy of a percutaneous injection of a mixture of autogenous bone marrow and crushed cancellous bone allografts for the treatment of simple bone cysts. MATERIALS AND METHODS: Fifteen patients with a simple bone cyst were enrolled in this study. The mean age was 13.5 years (range, 4-32 years), and the mean follow-up period was 13.2 months (range, 8-19 months). The radiographic signs of the resolution of the cyst were categorized as healed, healed with a defect, persistent and recurrent. The groups of healed and healed with a defect were designated the positive response groups. RESULTS: Fourteen patients responded to the treatment. Nine patients showed complete healing that was first seen radiographically at 3 months (range, 1-6 months). Five patients showed healing with a defect, but no patient required a second injection because the cysts were small and did not cause functional pain. There was no correlation between clinical responses and age, gender, location, cyst index and previous treatment modalities. One patient had a pathological fracture, which was treated successfully by open bone grafting with flexible intramedullary nailing. CONCLUSION: A percutaneous injection of a mixture of autogenous bone marrow and a crushed cancellous bone allograft may be an effective treatment for simple bone cysts.