PERCUTANEOUS ASPIRATION AND ETHANOL SCLEROTHERAPY FOR THYROID CYSTS

Benign thyroid cysts often recur after aspiration; the effectiveness o f tetracycline instillation in the case of recurrence has been questio ned. We, therefore, tested the efficacy of percutaneous ethanol inject ion in 20 patients with ''pure'' cyst relapsing after aspiration. Afte r evacuation, 95% ethanol was instilled under sonographic guidance and reaspirated 5 min later. The procedure was performed twice for larger cysts. Follow-up studies were carried out after 1, 3, 6, and 12 month s. In case of recurrence at 1 month, patients (n = 5) were submitted t o a second session. A slight burning sensation was the only adverse ef fect. No recurrences were observed at 3 and 6 month follow-up; only on e patient with recurrence after 1 month had relapsed at 12 months. A s ignificant shrinkage (P < 0.0001 vs. pretreatment) was observed in all other cases at 12 months; cysts were not detectable in seven patients (35%). No significant variations in thyroid hormone levels were detec ted during treatment or follow-up. Serum thyroglobulin levels markedly increased 3 h after ethanol injection. One month after treatment, thy roglobulin returned to pretreatment levels, thus excluding progressive thyroid damage. Percutaneous ethanol injection may prove a safe and e ffective tool for the therapy of thyroid cysts.