Endocrine Abstracts

Aim: To evaluate the long-term efficacy of percutaneous ethanol injection treatment (PEIT) as an alternative to thyroid surgery in symptomatic thyroid cysts with a structured protocol.

Methods: Seventy five subjects (48±12 years; 58% women) with symptomatic benign thyroid cysts relapsed after drainage were included. PEIT was conducted using the established procedure in our hospital, and the initial cyst volume, pain perceived by the patient and symptoms were assessed. In our procedure, a 21G needle was used and the volume of instilled alcohol was <2 ml without re-extraction in all cases. After >1 year follow-up, final cyst volume and symptoms improvement were evaluated.

Results: Symptoms were mainly compressive (91%). Mean maximum cyst diameter before drainage was 3.1±1.2 cm. A single session of PEIT was required to complete the procedure in 38% of patients, two in 33% and three or more in 29%. Mean maximum cyst initial volume was 17.4±15.7 ml before the first drainage and mean total volume extracted from the cysts in all procedures performed was 33.8±47.8 ml. After a mean follow-up period of 42±16 months, 98% of patients reported absence of symptoms. The final volume in the whole group was 1.7±2.6 ml with a mean volume percentage reduction of 88±13% (53–100%). A final volume reduction greater than 65% was observed in 90% of the cases. Reported pain during the procedure was virtually absent in 20.9%, mild in 54.2 and moderate in the 23.6% of the cases.

Conclusions: Our protocol is proposed as a long-term effective, safe and well-tolerated first-line treatment for symptomatic thyroid cysts.