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


CONCLUSIONS
Two-stage EA may be useful for the treatment of benign PCTNs.
Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Dong Wook
DW
Kim
D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D003560:Cysts / Q000601:surgery; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016606:Thyroid Nodule / Q000601:surgery*
D000431:Ethanol