title: Evaluation of efficacy, safety, pain perception and health-related quality of life of percutaneous ethanol injection as first-line treatment in symptomatic thyroid cysts.
abstract: BACKGROUND
  To evaluate the efficacy, safety, pain perception and health-related quality of life (QoL) of percutaneous ethanol injection treatment (PEIT) as an alternative to thyroid surgery in symptomatic thyroid cysts.
  
  
  METHODS
  Thirty consecutive patients (46 ± 10 years; 82% women) with symptomatic benign thyroid cysts relapsed after drainage were included. In all cases, cytology prior to treatment, maximum cyst diameter and volume were determined. PEIT was conducted using the established procedure, and the volume of fluid removed and pain perceived by the patient were assessed. In each procedure, the volume of alcohol instilled was <2 ml. After follow-up, final cyst diameter and volume were determined and the persistence of symptoms and QoL were assessed by a questionnaire (SF-36).
  
  
  RESULTS
  Mean symptom duration was 10 ± 20 months. A single session of PEIT was required to complete the procedure in 45% of patients, two in 31% and three in 13%. Mean initial maximum cyst diameter was 3.5 ± 1.0 cm and mean extracted liquid volume 61 ± 36 ml. During PEIT, 39% of patients experienced virtually no pain, 43% mild pain and 17% moderate pain. No complications of PEIT were observed. After 12.1 ± 1.4 months of follow-up, cysts were reduced more than 70% in volume in 86.3% of patients, more than 80% in 61.9% and more than 90% in 42%. On the health-related QoL SF-36 questionnaire, patient scores 6 months post-PEIT did not differ significantly from those of the healthy Spanish population. With respect to cosmetic complaints or local symptoms of compression, PEIT-treated patients presented an initial score of 22 ± 8 and 13 ± 5 after treatment (p < 0.05).
  
  
  CONCLUSIONS
  In our experience, percutaneous ethanol injection has prove to be an effective, safe and well-tolerated first-line treatment of symptomatic thyroid cysts.
authors.affiliation: Department of Endocrinology and Nutrition, Germans Trias i Pujol Health Science Research Institute and Hospital, CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Universitat Autònoma de Barcelona, Carretera de Canyet s/n, 08916, Badalona, Spain. reverter.germanstrias@gencat.cat.
authors.forename: Jordi L
authors.initials: JL
authors.lastname: Reverter
authors.affiliation: Department of Endocrinology and Nutrition, Germans Trias i Pujol Health Science Research Institute and Hospital, CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Universitat Autònoma de Barcelona, Carretera de Canyet s/n, 08916, Badalona, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Alonso
authors.affiliation: Department of Pathology, Germans Trias i Pujol Health Science Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Avila
authors.affiliation: Department of Endocrinology and Nutrition, Germans Trias i Pujol Health Science Research Institute and Hospital, CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Universitat Autònoma de Barcelona, Carretera de Canyet s/n, 08916, Badalona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Lucas
authors.affiliation: Department of Endocrinology and Nutrition, Germans Trias i Pujol Health Science Research Institute and Hospital, CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Universitat Autònoma de Barcelona, Carretera de Canyet s/n, 08916, Badalona, Spain.
authors.forename: Dídac
authors.initials: D
authors.lastname: Mauricio
authors.affiliation: Department of Endocrinology and Nutrition, Germans Trias i Pujol Health Science Research Institute and Hospital, CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Universitat Autònoma de Barcelona, Carretera de Canyet s/n, 08916, Badalona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Puig-Domingo
mesh_terms: D003560:Cysts / Q000000981:diagnostic imaging / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006304:Health Status; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D058748:Pain Perception; D011788:Quality of Life; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods; D013030:Spain / Q000453:epidemiology; D013959:Thyroid Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D013961:Thyroid Gland / Q000473:pathology*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D012597:Sclerosing Solutions; D000431:Ethanol