Endocrine Abstracts

JOINT97

Cystic formations of the thyroid and parathyroid glands are a common pathology due to the widespread use of ultrasound examination of the neck organs. True cysts of the thyroid (TC) and parathyroid glands (PC) are hormonally inactive and often have small sizes. But large cysts (10%) have clinical manifestations (pressure on the surrounding neck organs). The attitude towards this pathology is ambiguous - from radical removal to passive observation. Complications of TC and PC can be malignant transformation, ruptures and bleeding. We analyzed 96 clinical cases of TC (78) and PC (18). The size of the cysts varied from 20 to 114 mm, and the volume - from 6 to 360 ml (on average - 42.1 ± 24.2 ml). An algorithm of actions for this pathology is proposed. The first method of detecting cysts is ultrasound, which allows you to identify a cyst and measure its size. Initially, a complete cyst aspiration is performed for cytological examination and determination of TG and PTH levels. For punction TC the aspirate was yellow or brown, transparent or cloudy; for punction PC was colorless, transparent. The laboratory criteria are the levels of TG and PTH in the aspirate. If a high level of TG and a low level of PTH are detected in the TC, then obtaining the results of Bethesda 4,5,6 in the tissue component of the TC is the basis for surgical intervention. Bethesda 1,2 was the basis for the observation. PC were characterized by high levels of PTH (from 1218 to 3070 pg/ml; average 2012.5±946.7 pg/ml) and low levels of TG. The method of choice for their treatment is mainly observation. The recommended period of ultrasound examination is 3,6,12 months. If the contents accumulate in the cysts with a volume of up to 10 ml, repeated aspiration of the contents with subsequent ultrasound control is possible. In case of repeated accumulation of contents in thyroid cysts with a volume of more than 10 ml, sclerotherapy is preferable. Compression syndrome served as the basis for surgical intervention for TC in 3 cases, simultaneous operations were performed in 9 cases: in 6 cases – with a multi-node toxic goiter, in 3 - with thyroid cancer. When choosing methods of treatment for thyroid cysts, it is necessary to be guided by the fact that the treatment method should be as safe and minimally invasive as possible.