Efficacy and Safety of USG-guided 95% Ethanol Sclerotherapy in Solitary Benign Thyroid Cysts

Abstract

Thyroid nodule is frequently encountered thyroid diseases and is characterized by growth of abnormal tissues into the thyroid gland. Solitary nodule, defined as palpable, clinically detectable single nodule in otherwise normal thyroid gland, usually presents as asymptomatic mass that is discovered either by patient or clinician. Materials and methods: Twenty patients meeting inclusion criteria were included in study. Under strict aseptic conditions, using ultrasonographic guidance, fluid from cyst was aspirated and 95% ethanol was slowly (approximately 1 mL/minute) instilled into cavity to a volume of approximately 50% of volume of aspirated fluid. Patients were called for follow-up at an interval of 1 month for 3 months. Ultrasound was done to document volume of cyst, intracystic fibrosis and vascularity. Results: The mean pre-procedure volume of cysts was 3.605 cm3. After instillation of ethanol, the mean volumes at the end of 1st, 2nd and 3rd month of treatment were respectively 1.665 cm3, 0.9585 cm3 and 0.442 cm3. The mean volume reduction rates were calculated. Smaller cysts demonstrate better results than the larger cysts i.e., cyst size in range of 2.1–2.5 cm3 shows 97.14% reduction after 3 months, while cysts of >4.1 cm3 had mean reduction of 71.79% only. Conclusion: In the management of benign euthyroid cysts, USG-guided percutaneous ethanol injection is a cost-effective and efficient nonsurgical treatment modality with higher success rates. It is a relatively safe procedure with very low or no complication rates and has better patient compliance. Clinical significance: A non-surgical and cost-effective procedure can be treatment of choice for appropriately selected patient thus beneficial to greater majority of society.