Usefulness of two-stage ethanol ablation in the treatment of benign predominantly cystic thyroid nodules

摘要

Objective: The management of benign predominantly cystic thyroid nodules (PCTNs) differs depending on the institution or practitioner. This study aimed to assess the efficacy of two-stage ultrasound (US)-guided ethanol ablation (EA) in treating PCTNs.Methods: Over a 1-year period, two-stage EA was performed on benign PCTNs for 25 patients. After EA, each patient was followed up with thyroid US. The two-stage EA treatment consisted of an initial EA for the cystic component of the PCTN and subsequent treatment for the remaining solid component, if needed.Results: All 25 patients underwent EA for the cystic component of a PCTN and showed complete collapse of the cystic component on the follow-up US. Twenty patients were subsequently treated with one or more EA sessions because of the presence of a vascularized solid component, whereas 5 patients underwent no additional EA sessions because no vascularized solid component was detected on follow-up US. Of the 20 patients who underwent additional EA for a remaining solid component, complete ablation (n = 9), incomplete ablation (n = 7), and no response (n = 4) were observed on follow-up US. Of the 7 patients with incomplete ablation despite repeated EA, only 4 underwent radiofrequency ablation, and they showed complete ablation on follow-up US.Conclusion: Two-stage EA may be useful for the treatment of benign PCTNs.