Symptomatic nonfunctioning parathyroid cysts: Role of simple aspiration and ethanol ablation

• Published in: European journal of radiology Vol. 82; no. 2; pp. 316 - 320
• Main Authors: Sung, Jin Yong, Baek, Jung Hwan, Kim, Kyu Sun, Lee, Ducky, Ha, Eun Ju, Lee, Jeong Hyun
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01-02-2013
• Subjects: Adult; Aged; Combined Modality Therapy; Cysts - diagnostic imaging; Cysts - therapy; Ethanol - therapeutic use; Ethanol ablation; Female; Humans; Male; Middle Aged; Parathyroid; Parathyroid cyst; Parathyroid Diseases - diagnostic imaging; Parathyroid Diseases - therapy; Parathyroid hormone; Radiology; Recurrence; Retrospective Studies; Sclerosing Solutions - therapeutic use; Sclerotherapy - methods; Suction - methods; Treatment Outcome; Ultrasonography, Interventional - methods; Ultrasound; parathyroid hormone; PC; PTH; parathyroid cyst; ethanol ablation; EA; Parathyroid; US; ultrasound; Parathyroid hormone; Ethanol ablation; Parathyroid cyst; Ultrasound
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2012.10.009

Abstract Objectives To evaluate the outcomes of simple aspiration and ethanol ablation in the management of symptomatic nonfunctioning parathyroid cyst (PC). Methods We performed simple aspirations for 12 PCs in 12 patients from March 1997 to June 2010. PC was diagnosed if the aspirated fluid was clear colorless and showed an elevated parathyroid hormone (PTH) level. Ethanol ablation (EA) was performed for recurrent PCs. Simple aspirations were performed using 23-gauge needles and EAs using 18-gauge needles with 99% ethanol under ultrasound (US) guidance. We evaluated cyst volume, cosmetic score, symptom score, and complications. Results Mean follow-up period of all patients was 19.2 ± 12.9 months (median, 15.0 months; range, 7–40 months). Simple aspiration was successful in four patients, and the mean volume reduction after simple aspiration was 98.2 ± 3.5% (range, 92.9–100%). In eight recurrent cases, EA resulted in a significant decrease in volume ( P = 0.012), as well as in cosmetic ( P = 0.011) and symptom ( P = 0.01) scores at last follow-up; however two cases of primary failure of EA was treated by repeat EA. No major complications occurred in any patient. Conclusions For symptomatic nonfunctioning PCs, simple aspiration could be a first line procedure for diagnosis and treatment, while EA can be a subsequent treatment modality for recurrent cases.