Treatment of benign thyroid cysts by intracystic injection of OK-432.
BACKGROUND
Benign thyroid cysts have been successfully treated with nonoperative sclerotherapy. Although OK-432 is a safe and effective sclerosing agent used to treat benign cystic lesions, little is known about its effectiveness in thyroid cysts. This study tested the efficacy of OK-432 sclerotherapy for thyroid cysts.


METHODS
This was a prospective cohort study of 45 consecutive patients with benign thyroid cysts, as assessed by ultrasound (US)-guided biopsy. After evacuation, about 50% of the aspirated fluid volume was replaced with saline solution containing 0.1 to 0.2 mg OK-432. Recurrences were treated by repeat treatments, to a maximum of 3. Outcome was cyst volume on US 6 months after the last treatment.


RESULTS
Median pretreatment cyst volume was 15 mL (range, 3.5-110). Of the 45 patients, 33 (73%) were cured, defined as a residual cyst volume <1 mL; 20 were cured after 1 treatment, 8 after 2 treatments, and 5 after 3 treatments. Of the 12 patients (27%) not cured, 7 had >50% of the original cyst volume and 5 had <50% volume reduction; 3 of these patients underwent hemithyroidectomy. Multivariate analysis showed that the chance of success decreased with the number of previous aspirations and with increased cyst volume (P < .015 each). Transient mild local pain and low-grade fever were observed in 26 (58%) and 19 (42%) patients, respectively, but there were no significant treatment-related complications.


CONCLUSIONS
Intracystic injection of OK-432 may be a safe and effective treatment for benign thyroid cysts.
Roh
Jong-Lyel
JL
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. rohjl@amc.ac.kr
Park
Chan
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010844:Picibanil / Q000008:administration & dosage*; D011446:Prospective Studies; D015911:Sclerotherapy; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
D000970:Antineoplastic Agents; D010844:Picibanil