Percutaneous ethanol injection for benign cystic thyroid nodules

Mustafa T Ahmed, Mohamed B M. Kotb, Mohamed S Shahine, Hassan M Harby, Mahmoud T A. Mohamed

DOI:10.4103/JCMRP.JCMRP_95_18  

Aim The aim of this study was to evaluate the efficacy and safety of percutaneous ethanol injection (PEI) in managing predominantly cystic benign thyroid nodules in euthyroid individuals and avoid complication of surgery, provide symptomatic, cosmetic improvement, decrease the hospital stay and rapid recovery. Patients and methods The study is an experimental clinical trial. Twenty patients (34.20 ± 7.52 years; 60% women) with symptomatic benign thyroid cysts were included. In all cases, cytology before treatment, thyroid function before and after PEI, maximum cyst diameter, and volume were determined. PEI was conducted using 99% sterile ethanol, and pain perceived by the patients was assessed. After follow-up, final cyst diameter and volume were determined. Results The patients mean age was 34.20 ± 7.52 years, and 60% were females. A single session of PEI was required to complete the procedure. Mean initial maximum cyst diameter was 4.3 cm. Mean reduction in the cyst volume was 94.38%±4.04. During PEI, 40% of patients experienced pain. No complications of PEI were observed. After 6 months of follow-up, cysts were reduced more than 95% in 75% of patients, and reduced less than 95% in 25% of patients. Conclusion PEI can be the first-line treatment of benign thyroid cysts. It is a highly efficacious and safe technique with improvement in clinical conditions, with very low recurrence rate, and with no complications except pain associated with injection, which can be managed by analgesic.