Thyroid Cyst Ethanol Ablation PEI 101: What are you waiting for? Stop Draining the Cyst and Don’t Go to Surgery
2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer
Call Matt at 310-393-8860 or [email protected] for cyst treatment details in my office without surgery.
Richard Guttler MD,FACE,ECNU
What is the role of medical or surgical therapy for benign thyroid nodules?
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Routine TSH suppression therapy for benign thyroid nodules in iodine sufficient populations is not recommended. Though modest responses to therapy can be detected, the potential harm outweighs benefit for most patients.
Recurrent cystic thyroid nodules with benign cytology should be considered for surgical removal or percutaneous ethanol injection (PEI) based on compressive symptoms and cosmetic concerns. Asymptomatic cystic nodules may be followed conservatively.Cystic nodules that are cytologically benign can be monitored for recurrence (fluid reaccumulation), which can be seen in 60%–90% of patients. For those patients with subsequent recurrent symptomatic cystic fluid accumulation, surgical removal, generally by hemithyroidectomy, or PEI are both reasonable strategies. Four controlled studies demonstrated a 75%–85% success rate after PEI compared with a 7%–38% success rate in controls treated by simple cyst evacuation or saline injection. Success was achieved after an average of two PEI treatments. Complications included mild to moderate local pain, flushing, dizziness, and dysphonia