Efficacy and safety of USG-guided ethanol sclerotherapy in cystic thyroid nodules

To study the effectiveness and safety of USG-guided ethanol sclerotherapy in cystic thyroid nodules.

USG of the thyroid gland was performed in 54 patients suspected to have a thyroid nodule on clinical examination. All patients with a predominantly cystic nodule (i.e., when> 2/3 rd of the nodule was cystic) were included in the study. Ethanol was injected into the cyst under USG guidance. The amount of ethanol injected was about 50% of the amount of aspirated fluid. Follow-up USG was done every month for 3 months; ethanol was re-injected when there was no significant reduction in the cyst volume. The initial cyst volume was compared with the final volume; statistical significance was assessed using the paired t-test.

USG revealed predominant cystic nodules in 16 of the 54 patients. Fifteen patients were selected for the study. Following ethanol sclerotherapy, four out of the 15 patients (26.6%) showed complete disappearance of the cyst and nine (60%) showed significant reduction in the cyst volume (i.e., reduction of cyst volume by >/=50% of initial volume). Only two patients did not show significant reduction in cyst volume; both these patients had nodules with an initial volume of >/=20 cc. There were no complications attributable to ethanol injection during follow-up.

Ethanol sclerotherapy is an effective and safe treatment for benign cystic thyroid nodules with volumes of < 20 cc. Cystic nodules with volume> 20 cc may need more number of alcohol injections and longer follow-up.