Thyroid Tumor Ablation 101: Two Step Ethanol Ablation for Mixed Cyst Solid Benign Nodules

Thyroid Tumor Ablation 101: Two Step Ethanol Ablation for Mixed Cyst Solid Benign Nodules

Thyroid Tumor Ablation 101: Two Step Ethanol Ablation for Mixed Cyst Solid Benign Nodules
Thyroid Tumor Ablation 101: Two Step Ethanol Ablation PEI for Mixed Cyst Solid Benign Nodules.
Comments on this paper by Dr.Guttler
jt-nodule-before-pei
Classic spongiform cystic nodule for ethanol ablation PEI.
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First drain and treat the cystic component.
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Clear fluid parathyroid cyst usually has no solid part unless it had a recent bleed.
img_0694
Mixed cyst solid for two step ethanol ablation.
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200 proof medical grade ethanol is used in my center.
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Pure cyst are easily treated with ethanol.

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

Kim DW  
.Endocr Pract. 2014 Jun;20(6):548-55.
  1. First drain and treat the cystic component.
  2. Return to treat the solid component.
  3. 25 patients were studied.
  4. 25/25 had complete collapse of the cyst component.
  5. 20/25  were treated for Doppler positive solid component.
  6.  9/20 patients who underwent additional EA for a remaining solid component, complete ablation (n = 9),
  7. 7/20 incomplete ablation (n = 7),
  8. 4/20 and no response (n = 4)
  9.  4/7 patients with incomplete ablation underwent radiofrequency ablation, and they showed complete ablation on follow-up US.
  10.  Two-stage EA may be useful for the treatment of benign PCTNs.

PEI therapy is not a painful treatment and is safe. Benign thyroid or parathyroid cysts or thyroid mixed cyst/solid benign nodules can be treated without a surgery.

Call Matt at 310-393-8860 or email thyroid.manager@protonmail.com. for details. The other uses for ethanol PEI is to treat recurrent thyroid cancer in neck lymph nodes instead of another neck surgery, and for primary micro-papillary cancer instead or surgery or active surveillance.

Richard Guttler MD,FACE,ECNU.

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