Efficacy of thyroid cyst sclerotherapy with polidocanol

Simple cysts are a common form of thyroid nodules. If the cyst is symptomatic, recurs after fine needle aspiration or increases in size, sclerotherapy of the cyst is indicated. Polidocanol can be used as a sclerosing agent, but there are few studies evaluating the efficacy of polidocanol in the sclerotherapy of thyroid cysts.

We conducted a clinical retrospective study in adult patients diagnosed with a simple thyroid cyst with largest diameter greater than 15 mm. Patients were treated with thyroid cyst sclerotherapy with polidocanol (group A, N = 36), ultrasound-guided fine-needle evacuation of the cyst (group B, N = 41) or they received no treatment and were managed only by follow-up (group C, N = 28). Thereafter, the size of the thyroid cyst at least 12 months after the baseline evaluation was recorded.

The three groups of patients did not differ significantly in terms of gender, thyrotropin level, thyroid antibody positivity or thyroglobulin level. However, they differed significantly in age (46.5 ± 15.8 years for group A, 51.2 ± 17.4 years for group B and 65.8 ± 13.7 years for group C, p < 0.001). The three patient groups differed significantly in the initial volume of cysts (20.1 ± 13.8 mL for group A, 15.0 ± 17.8 mL for group B and 4.2 ± 4.5 mL for group C, p < 0.001). In groups A and B, the final volume of the cyst was significantly lower than the initial volume (7.6 ± 12.1 mL, p < 0.001, and 6.1 ± 10.4 mL, p < 0.001, respectively), but not in group C (5.3 ± 7.9 mL). There was no significant difference in final cyst volume between the three groups (p = 0.764).

The results of our study show that sclerotherapy of thyroid cysts with polidocanol is an effective and safe method for the treatment of large thyroid cysts. Currently, such treatment is more commonly used in younger patients.