Ultrasound guided percutaneous ethanol injection of parathyroid adenomas.

Study objective: The objective of this retrospective study was to report th e results of ethanol injection in parathyroid adenomas. Patients and method: Since 1988, 31 patients with inoperable primary hypert hyroidism have been treated by ultrasound-guided percutaneous ethanol injec tion into the adenoma. The main surgical contraindications were heart failu re (n = 12) and age over 85 years (n = 11). Plasma calcium and PTH were mea sured 48 hours after ethanol injection and during subsequent follow-up. Results: Patients had one to three ethanol injections. With a mean 5-year f ollow-up, total success with normal plasma calcium anti PTH levels was achi eved in 20 patients (64.5%), 4 of whom underwent another ethanol injection after 1 to 3 years. Partial success with correction of plasma calcium only was achieved in 9 patients (29%) resulting in an obvious clinical benefit. Failure was observed in 2 patients (6.5%) with nodular goiter, probably due to incorrect localization of the adenoma. Treatment was always well tolera ted and no major side effect was observed. Conclusion: Ultrasound-guided percutaneous ethanol injection of parathyroid adenoma is effective in most cases of hyperparathyroidism and very useful in patients with a high surgical risk. The need for precise ultrasound loca lization of the adenoma is the main limitation of this treatment. (C) 2000 Editions scientifiques et medicales Elsevier SAS.