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Abstract No. 245 EE: Ethanol ablation of cervical lymph nodes for percutaneous treatment of thyroid carcinoma metastases

https://doi.org/10.1016/j.jvir.2009.12.031Get rights and content

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Learning Objectives

Learn the techinique of ethanol ablation of cervical lymph nodes. Learn the utility of this procedure and complications that can occur from this procedure.

Background

Routine ultrasound follow-up in patients with thyroid carcinoma can identify small lymph nodes embedded within scar tissue surrounding the previous surgical bed. This scar tissue often causes marked distortion of the normal tissue planes within the neck, making surgical dissection difficult even for experienced surgeons. Such surgical reexploration of the neck can be associated with a high rate of morbidity in these patients. Radioactive ablation may also be ineffective in some patients due to

Clinical Findings/Procedure Details

Patients with a small number of neck lymph nodes are eligible for ethanol ablation. After superficial anesthesia, lidocaine is also infiltrated in the fascial tissues around lymph node. A 25-gauge needle is attached to a tuberculin syringe containing 95% ethanol. Each of the nodes is punctured and injected in multiple sites. Typically, the deepest portion or one of the poles of a node is treated first with a small amount of ethanol (0.05-0.1 mL). As the ethanol is injected, that portion of the

Conclusion and/or Teaching Points

Ethanol ablation of cervical lymph nodes is an effective treatment for locally metastatic thyroid carcinoma. Careful technique is necessary to ensure that the ethanol does not spill into surrounding tissues. Multiple treatment sessions maybe necessary for complete treatment of a lymph node.

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