Thyroid functional autonomy — sclerotherapy and radioactive iodine therapy: case report

Thyroid functional autonomy (TFA) is the most frequent reasons of subclinical or manifest thyrotoxicosis. Diagnosis of the causes of thyrotoxicosis (destruction or increased functional activity of the thyroid tissue in nodular and diffuse thyroid pathology) is a key point in determining the management of patients with this pathology. Scintigraphy is the method of choice in differential diagnosis of the causes of thyrotoxicosis assessing the functional state of the thyroid gland. Thyroid scintigraphy can be performed using 99mTc-pertechnetate. After normalization of the level of thyroid hormones is confirmed, radical treatment is recommended. It could be surgery or radioactive iodine therapy (RAI). In some cases, especially in the elderly women, TFA is combined with thyroid nodules (TN), which can cause pressure symptoms, cosmetic complaints, and thyroid dysfunction. Minimally invasive treatments, such as percutaneous ethanol injection (PEI) sclerotherapy, has been proposed, especially for pressure symptoms and cosmetic complaints, as an alternative to surgery. The presented clinical case will demonstrate the possibility of use sclerotherapy and RAI for the successful treatment of TFA with TN.