Endocrine Abstracts

Objectives: To evaluate the efficacy, safety and patient’s pain perception of percutaneous ethanol injection treatment (PEIT) as an alternative to surgery in symptomatic thyroid cysts.

Patients and methods: Thirty consecutive patients (mean age: 46±10 years; 82% women) with symptomatic thyroid cysts relapsed after drainage were included. In all cases, cytology prior to treatment, maximum cyst diameter and volume were determined. PEIT was conducted using the established procedure, and the volume of fluid removed and pain perceived by the patient were assessed. In each procedure, the volume of alcohol instilled was <2 ml. After follow-up, final cyst diameter and volume were determined and the persistence of symptoms was assessed by questionnaire.

Results: Mean symptom duration was 10±20 months. All the cases had a benign cytology. A single session of PEIT was required to complete the procedure in 45% of patients two in 31% and three in 13%. Mean initial maximum cyst diameter was 3.5±1.0 cm and mean extracted liquid volume 61±36 ml. During PEIT, 39% of patients experienced virtually no pain, 43% mild pain and 17% moderate pain. No complications of PEIT were observed. After 9±3 months follow-up, cysts were reduced more than 70% in volume in 86.3% of patients, more than 80% in 61.9% and more than 90% in 42%. Final mean maximum cysts diameter was 1.3±0.6 cm. With respect to cosmetic complaints or local symptoms of compression, PEIT-treated patients presented an initial score of 22±8 and 13±5 after treatment (P<0.05) and 47% of cases reported a score of 10 (absence of symptoms).

Conclusions: In our experience, percutaneous ethanol injection has prove to be an effective, safe and well-tolerated first-line treatment of symptomatic thyroid cysts.