The introduction of new diagnostic methods for the evaluation of solitary
thyroid nodules allows for unquestionable differentiation between malignant and benign lesions in most cases. It makes therapeutic procedure other than surgical
therapy possible. One of the procedures is the percutaneous alcohol
sclerotherapy (PSA). It is the most commonly used for the treatment of thyroid
cysts and autonomous
thyroid nodules. PSA was first proposed by Livraghi in 1990 as possible
therapy for autonomously functioning
thyroid nodules. This method is based on the administration of a limited amount of sterile alcohol into the
thyroid nodule under direct ultrasonografic control. The application of PSA according to the worked out procedure gives a permanent remission of thyroid
cysts in most cases and the 85-100% decrease of
thyroid nodule volume. In the case of "toxic" and "pretoxic" type of nodules, a normalization of serum FT3, FT4 and TSH level occurs. Scintigraphy shows recovery of extranodular uptake of
radionuclide and effacement of previously hot area of thyroid scintiscan. The following complications were observed after PSA:
pain of the injection site, local
hematoma,
fever,
sinus tachycardia, transient
dysphonia. The intensity of these complications is generally low.