The Effect of Minocycline Sclerosing Therapy on Cystic Thyroid Nodules / 대한내과학회지

ABSTRACT

OBJECTIVES: We studied the efficacy and safety of repeated aspiration therapy and minocycline sclerotherapy for cystic thyroid nodules in the euthyroid patients and the factors which might appear to influence the outcome of therapy. SUBJECT AND METHODS: 114 patients with predominantly cystic thyroid nodules were studied. All of the patients underwent the first aspiration therapy, and patients with recurrent cystic lesions after the first aspiration treatment underwent repeated aspiration therapy or additive minocycline sclerotherapy. The patients were followed up ultrasonically 1 and 3 months, and every three month thereafter after the treatments. RESULTS: In 106 patients of 114 patients, cumulative success rate of the treatments was 54.6%. Cumulative success rate of only aspiration treatments(n=81) was 45.1%. 83 patients of 114 patients was recurred after the first aspiration therapy. In these patients, Cumulative success rate of repeated aspiration treatments(n=58) was 24.1%, Cumulative success rate of additive minocycline sclerotherapy(n=25) was 88.0%. Treatment modalities and longest diameter of the lesions significantly influenced the outcome of the trea tments. The effect of the larger longest diameter of cystic thyroid nodule would tend to reduce the cummulative success rate, and the cutoff point of the longest diameter was 4.5 cm. There were no significant adverse effects except for transient pain around the injection site in 12 patients (46%). Cytologic study showed 4 (3.5%) of 114 patients to be malignant. CONCLUSION: Minocycline sclerotherapy of cystic thyroid nodules is a useful and tolerable non-operative therapeutic method in patients with recurrent cystic thyroid nodules after repeated aspiration therapy. The size of a cystic thyroid nodule influence the outcome of aspiration therapy but may not inflcence the outcome of minocycline sclerotherapy.