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Evaluation of fibrous-sclerotic changes in the thyroid gland from a surgeon’s perspective. Part III

https://doi.org/10.17238/2072-3180-2026-1-246-252

Abstract

Introduction. Fibro-sclerotic changes in the thyroid gland during minimally invasive interventions, particularly chemical ablation, are a targeted and planned outcome that determines the structure, size, and morphology of the destroyed areas of the gland. Changes in the size and volume of cysts, nodules, and thyroid tumors as a result of the use of chemical reagents are an expected outcome of induced progressive fibrosis and sclerosis of the tissues, which manifest as a decrease in the size of the focal lesion and a change in its pathomorphological characteristics.

Purpose of the study. To evaluate, according to the literature data, the indications for the use of the chemical ablation technique, the variants of its application, the dynamics of changes and the outcomes of fibrosclerotic changes in the tissue and nodular formations of the thyroid gland of various morphological structure.

Materials and methods. Search for literature sources in the E-library, PubMed, and Scopus databases using the keywords “fibrosis”, “sclerosis”, “calcification”, and “hyalinization” in conjunction with the phrases “sclerotherapy for thyroid pathology” and “chemical ablation for thyroid pathology”.

Results. When using the minimally invasive treatment method of "chemical ablation" in patients with thyroid pathology, the expected result is the regression of the focal formation and the progressive replacement of the proliferating thyroid tissue with fibrosis, sclerosis, hyalinosis, and calcification.

Conclusion. Today, chemical ablation is one of the components of the therapeutic algorithm for treating patients with thyroid pathology.

About the Authors

A. M. Shulutko
Federal State Autonomous Educational Institution of Higher Education Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Shulutko Alexandr Mikhailovich – Professor of the Department of Faculty Surgery №2 named after G.I. Lukomski, MD, Professor

Trubetskaya str., 8 – 2, Moscow, 119047



Yu. K. Aleksandrov
Federal State Budgetary Educational Institution of Higher Education Yaroslavl State Medical University
Russian Federation

Aleksandrov Yuri Konstantinovich – Professor of the Department of Surgical Diseases with a course in endocrine Surgery named after N.P. Pamputis, MD, Professor

Revolutsionnaya str., 5, Yaroslavl, 150000



V. I. Semikov
Federal State Autonomous Educational Institution of Higher Education Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Semikov Vasily Ivanovich – Professor of the Department of Faculty Surgery №2 named after G.I. Lukomski, MD, Professor

Trubetskaya str., 8 – 2, Moscow, 119047



J. A. Boblak
Federal State Autonomous Educational Institution of Higher Education Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Russian Federation

Boblak Julia Alexandrovna – Assistant of the Department of Faculty Surgery No. 2 named after G.I. Lukomsky

Trubetskaya str., 8 – 2, Moscow, 119047



References

1. Semikov V.I., Aleksandrov Yu.K., Shulutko A.M., Boblak Yu.A. Evaluation of fibrous-sclerotic changes in the thyroid gland from a surgeon’s perspective. Part 1. Moscow Surgical Journal, 2025, № 2, pp. 192–199. (In Russ.) https://doi.org/10.17238/2072-3180-2025-2-192-199

2. Shulutko A.M., Aleksandrov Yu.K., Semikov V.I., Boblak Yu.A. Evaluation of fibrous-sclerotic changes in the thyroid gland from a surgeon’s perspective. Part 2. Moscow Surgical Journal, 2025, № 4. (In Russ.)

3. Kim D.W. Ethanol ablation of thyroid nodules. Thyroid Radiofrequency Ablation, 2024. https://doi.org/10.1007/978-3-03165288-2_24

4. Park A.W., Mauri G., Kim J.H. Thyroid Radiofrequency Ablation: A Comprehensive Guide. Cham, Springer, 2024, pp. 339. https://doi.org/10.1007/978-3-031-65288-2

5. Trimboli P., Castellana M., Sconfienza L.M. Efficacy of thermal ablation in benign non-functioning solid thyroid nodules: a systematic review and meta-analysis. Endocrine, 2019. https://doi.org/10.1007/ s12020-019-02019-3

6. Korkusuz Y., Gröner D., Raczynski N. Thermal ablation of thyroid nodules: are radiofrequency ablation, microwave ablation and high-intensity focused ultrasound equally safe and effective methods? European Radiology, 2018, vol. 28, № 3, pp. 929–935. https://doi.org/10.1007/s00330-017-5039-x

7. Qian Y., Li Z., Fan C., Huang Y. Comparison of ultrasound-guided microwave ablation, laser ablation, and radiofrequency ablation for the treatment of elderly patients with benign thyroid nodules: a meta-analysis. Experimental Gerontology, 2024, vol. 191, рр. 112425. https://doi.org/10.1016/j.exger.2024.112425

8. Livraghi T., Paracchi A., Ferrari C. Treatment of autonomous thyroid nodules with percutaneous ethanol injection: preliminary results. Radiology, 1990, vol. 175, № 3, pp. 827–829. https://doi.org/10.1148/radiology.175.3.2188302

9. Bennedbaek F.N., Karstrup S., Hegedüs L. Percutaneous ethanol injection therapy in the treatment of thyroid and parathyroid diseases. European Journal of Endocrinology, 1997, vol. 136, № 3, pp. 240–250. https://doi.org/10.1530/eje.0.1360240

10. Kim I.V., Kuznetsov N.S., Vanushko V.E. Sclerotherapy for nodular colloid goiter. Khirurgiya, 2005, № 9, pp. 14–18. (In Russ.)

11. Felício J.S., Conceição A.M., Santos F.M., Sato M.M., Bastos F.A., Braga de Souza A.C., Koury C.C., Neto J.F., Cunha de Melo F.T., Carvalho C.T., Arbage T.P., Junior A.B., de Rider Brito H.A., Júnior M.O., Resende F.S., Peixoto A.S., Felício K.M. Ultrasound-guided percutaneous ethanol injection protocol to treat solid and mixed thyroid nodules. Frontiers in Endocrinology (Lausanne), 2016, vol. 7, рр. 52. https://doi.org/10.3389/fendo.2016.00052

12. Privalov V.A., Seliverstov O.V., Revel-Muroz Zh.A. Percutaneous laser-induced thermotherapy of nodular goiter. Khirurgiya, 2001, № 4, pp. 10–13. (In Russ.)

13. Reverter J.L., Alonso N., Avila M., Lucas A., Mauricio D., Puig-Domingo M. Evaluation of efficacy, safety, pain perception and health-related quality of life of percutaneous ethanol injection as firstline treatment in symptomatic thyroid cysts. BMC Endocrine Disorders, 2015, vol. 15, рр. 73. https://doi.org/10.1186/s12902-015-0069-3

14. Merchante Alfaro A.Á., Garzón Pastor S., Pérez Naranjo S., González Boillos M., Blanco Dacal J., Maravall Royo F.J., Abellán Galiana P., Morillas Ariño C. Percutaneous ethanol injection therapy as the first line of treatment of symptomatic thyroid cysts. Endocrinology, Diabetes & Nutrition, 2021, vol. 68, № 7, pp. 458–464. https://doi.org/10.1016/j.endien.2021.11.011

15. Hegedüs L., Frasoldati A., Negro R., Papini E. European Thyroid Association survey on use of minimally invasive techniques for thyroid nodules. European Thyroid Journal, 2020, vol. 9, № 4, pp. 194–204.

16. Kuznetsov N.A., Rodoman G.V., Sumedi I.R., Shalaeva T.I., Sviridenko N.V., Cherner V.A. Sclerotherapy in the treatment of functional thyroid autonomy. Khirurgiya. Zhurnal imeni N.I. Pirogova, 2010, № 8, pp. 11–15. (In Russ.)

17. Gumerova G.T., Fazlyeva A.F., Klimets S.P., Suleimanova N.S., Ishbulatova A.I., Asfandiyarova I.V., Neryakhin A.D., Makaryin V.A., Uspenskaya A.A. Step-by-step treatment of nodular goiter with compression of neck organs: sclerotherapy and radiofrequency ablation. Endocrine Surgery, 2024, vol. 18, № 4, pp. 39–49. (In Russ.) https://doi.org/10.14341/serg12843

18. Clark R.D.E., Luo X., Issa P.P., Tufano R.P., Kandil E. A clinical practice review of percutaneous ethanol injection for thyroid nodules: state of the art for benign cystic lesions. Gland Surgery, 2024, vol. 13, № 1, pp. 108–116. https://doi.org/10.21037/gs-22-568

19. Cherenko S.M. Application of a new biological adhesive preparation “Polymerfibrin” in thyroid surgery. Likarska Sprava, 1998, № 1, pp. 160–164. (In Ukr.)

20. Antonelli A., Campatelli A., Di Vito A. Comparison between ethanol sclerotherapy and emptying with injection of saline in treatment of thyroid cysts. Clinical Investigator, 1994, vol. 72, № 12, pp. 971–974.

21. Krystev I., Aleksiev I., Katranushkova N. Role of anaerobic microorganisms in the genesis of thyroiditis and thyroid cysts. Problems of endocrinology, 1993, № 2, pp. 16–18. (In Russ.)

22. Giammarile F., Bielli E., Fattapposta A. Sclerotherapy of thyroid cysts with tetracycline hydrochloride. Minerva Endocrinologica, 1994, vol. 19, pp. 143–147.

23. Raeymaeckers S., Tosi M., Sol B. Sonographic changes in the thyroid gland after sclerotherapy with doxycycline can be mistaken for thyroid cancer. Thyroid Research, 2023, vol. 16, рр. 33. https://doi.org/10.1186/s13044-023-00177-1

24. Pomorski L., Bartos M., Matejkowska M., Kuzdak K. The influence of a single acetic acid and lactic acid injection on rat normal thyroid tissue. Ceska Patologie, 2002, vol. 38, № 3, pp. 107–112.

25. Rodoman G.V., Sumedi I.R., Sviridenko N.V., Shalaeva T.I., Meloyan M.M. Sclerotherapy as an alternative to surgery in the treatment of patients with recurrent nodular goiter. Surgery. The N.I. Pirogov journal, 2020, № 5, pp. 87–92. (In Russ.)

26. Bartos M., Pomorski L. The influence of a single ethanol injection on normal thyroid tissue of the rat. Cytobios, 2000, vol. 101, № 397, pp. 123–130.

27. Crescenzi A., Papini E., Pacella C.M., Rinaldi R., Panunzi C., Petrucci L., Fabbrini R., Bizzarri G.C., Anelli V., Nardi F., Marinozzi V. Morphological changes in a hyperfunctioning thyroid adenoma after percutaneous ethanol injection: histological, enzymatic and sub-microscopical alterations. Journal of Endocrinological Investigation, 1996, vol. 19, № 6, pp. 371–376. https://doi.org/10.1007/BF03344972

28. Pomorski L., Bartos M. Histologic changes in thyroid nodules after percutaneous ethanol injection in patients subsequently operated on due to new focal thyroid lesions. APMIS, 2002, vol. 110, № 2, pp. 172–176. https://doi.org/10.1034/j.1600-0463.2002.100208.x

29. Vetshev P.S., Chilingaridi K.E., Cherepenin M.Yu. Minimally invasive technologies in the treatment of benign thyroid lesions. Khirurgiya, 2002, № 7, pp. 61–64. (In Russ.)


Review

For citations:


Shulutko A.M., Aleksandrov Yu.K., Semikov V.I., Boblak J.A. Evaluation of fibrous-sclerotic changes in the thyroid gland from a surgeon’s perspective. Part III. Moscow Surgical Journal. 2026;(1):246-252. (In Russ.) https://doi.org/10.17238/2072-3180-2026-1-246-252

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