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 alternarive 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 sized and volume of nodule. The results were as follows: 1) with 0.5-0.8cc tetracycline injection for three times, the volume of nodule was reduced after PTI; About 2.3×1.7×0.7cm sized
nodule was
reduced to about 1.3×1.0×0.5cm size 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 experience good results in a 22-year-old woman suffered from AFTN treated with PTI and think that PTI could be the effective, safe, simple, wel tolerable procedure in the treatment of AFTN. (J Kor Soc Endocrinol 9: 258-264,
1994)
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