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Surgery for Benign Thyroid Cystic Nodules? Not Anymore! There is a New Medical Treatment Using Injection of Alcohol call PEI

Posted Jun 24 2009 2:05pm
42 year old female with a large visible mass on the right thyroid lobe. She had local symptoms and did not like the looks of the mass, as it distorted her thin neck. Her thyroid tests were normal, but a complex cyst was seen in the right lobe on ultrasound.
An FNA and drainage of the cyst fluid was done. The free hand FNA done without ultrasound guidance, was negative for cancer, but the mass recurred in 4 weeks. The endocrinologist referred her to a surgeon to remove the mass. She was referred to me for a second opinion on the need for surgery. Of course she had searched the web for alternatives to surgery, and found my website.
She learned about my Ethanol Injection Method (PEI) for recurrent Cysts. The cyst was 11 ml in size and had a complex solid component. An ultrasound guided FNA aimed directly at the solid component to R/O cystic papillary thyroid cancer was negative. The injection of ethanol after draining the cyst was successful. She had slight burning sensation as the needle was removed, but othewise there was no other side effects. She returned in a month to see the effects of the ethanol on the cyst. When she walked int the examining room, she said, "The thing is gone". The large visible mass was not seen on inspection, or was it felt on palpation. The mass was still there but was markedly reduced. From the original 11 ml to 0.6 ml. That was a >90%
reduction in size. The average reduction noted in the literature is 80%. She did not need surgery, because the reasons for surgery did not exist anymore.They are fear of cancer, obstruction,and removing an ugly mass for cosmetic reasons.

Get a second opinion before having thyroid surgery for a cyst.

Good Lck,Dr.G.
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