A Case of Autonomously Functioning Thyroid Nodule Treated with Percutaneous / 대한내분비학회지

ABSTRACT

Autonomously functioning thyroid nodules(AFTNs) are so named because they presumably are independent of TSH for growth and function. In general, surgery and radioactive iodine are effective therapies but reluctant to use because of complications such as hypothyroidism or cosmetic problems.Percutaneous ethanol injection therapy(PEIT) under sonographic guidance has recently been introduced as alternative therapy. But its adverse effects such as severe local pain, subcutaneous hematoma or palsy of the recurrent nerve are not negligible, therefore sufficient skill is required.In this case, the levothyroxine therapy in reducing the size of colloid thyroid nodules was not apparent within three months. Therefore we selected another sclerosing therapeutic method such as percutaneous tetracycline injection(PTI) and followed up thyroid function test, thyroid scan, ultrasonographical size and volume of nodule. The results were as follows 1) With 0.5-0.8 cc tetracycline injection for three times, the volume of nodule was reduced after PTI; About 2.3 X 1.7 X 0.7 cm sized nodule was reduced to about 1.3 X 1.0 X 0.5 cm sized nodule. 2) There were significant improvements of TFT(subclinical hyperthyroidism to euthyroidism) and thyroid scan(solitary hot nodule to completely ablated AFTN) during 9 months follow-up after PTI as compared with the base line study. In conclusion, we experienced good results in a 22-year-old woman suffered from AFTN treated with PTI and think that PTI could be the effective, safe, simple, well tolerable procedure in the treatment of AFTN.