Two Large Symptomatic Thyroid Cysts in Multinodular Goiters Treated with Ultrasound-Guided Ethanol Sclerotherapy

Ultrasound-guided ethanol sclerotherapy is used as an alternative to surgery in the treatment of thyroid cysts. The method is effective, repeatable, and cheap and can be performed in an outpatient setting. The risks are related to ethanol leaking into the surrounding tissues but serious complications are only seen in a small proportion of procedures. The approach is successfully used to treat small- and medium-sized cysts of less than 50 ml of volume. It may also be attempted in large, mostly complex cysts causing significant mechanical problems. These are two reports documenting cases of successfully treated large symptomatic cysts (80 and 170 ml) in multinodular goiters in elderly patients with co morbidities who either refused a surgical approach or in whom surgery was ruled out.