safety and effectiveness of percutaneous ethanol injection as a treatment for locally recurrent papillary thyroid carcinoma

Background: reoperation for recurrent papillary thyroid cancer (ptc) is associated with a high risk of complications and limited success in achieving sustained remission. percutaneous ethanol injection (pei) presents a potential non-surgical alternative for managing locally recurrent ptc. objectives: this study aimed to evaluate the safety and effectiveness of pei in treating recurrent ptc. methods: from october 2017 to september 2021, pei was administered to 39 recurrent lesions (23 lateral and 16 central) in 17 patients with ptc. the median follow-up duration was 21.4 months (range, 4.1 - 37.9), with ethanol injections delivered every 3 months under ultrasound (us) guidance as needed. results: most patients tolerated the treatment well, experiencing only mild local pain, though one patient reported horner syndrome following the procedure. in terms of treatment frequency, 31 lesions required 3 or fewer injections, while the remaining lesions required more. the mean initial volume of the lesions decreased from 0.12 mm³ (range: 0.06 - 0.34 mm³) to 0.03 mm³ (range: 0.0 - 0.14 mm³), representing an average reduction of 72.6% (range: 20.0 - 100.0%). of the 39 lymph nodes treated in 17 patients, 21 lymph nodes (54%) were completely resolved. seven lymph nodes remain under ongoing ethanol treatment, while 11 lymph nodes in 4 patients were addressed with alternative treatments, including surgery. conclusions: percutaneous ethanol injection appears to be a safe and effective treatment option for managing locally recurrent thyroid carcinomas in select patients. however, further comparative, prospective, long-term studies are needed to evaluate pei’s impact on patient survival and recurrence rates.