Percutaneous Ethanol Ablation for Management of Cystic Thyroid Nodules: A Case Report

Abstract
Introduction: Percutaneous Ethanol Ablation (PEA) has been recommended as the first-line treatment option for symptomatic benign cystic or predominantly cystic thyroid nodules, and it has been shown to be more effective and safer than other techniques in previous studies. Here, we present a case of a 44-year-old man with thyroid nodules who underwent PEA.Case Presentation: We report the case of a 44-year-old man with a painless mass that is getting bigger on his right neck. The physical examination measured 3.0 × 3.0 × 3.0 cm, mobile on swallowing, no pain on palpation. Thyroid function tests show a euthyroid state (TSH 2.4 mIU/L, FT4 1.2 ng/dL). The ultrasound examination in January 2020 showed a colloid cyst on the right thyroid, measured 3.03 × 2.82 × 3.56 cm (TIRADS 1). Cytological examination showed the results of non-infectious cystic fluid. The patient underwent US-guided PEA using 7 ml of ethanol by the moving-shot technique. The procedure was well tolerated by the patient and no adverse events were noted. A week after the procedure, there was a visible and progressive reduction of the nodule with no complaint from the patient. A month after the procedure, the patient came back with no recurrences, complaints, or other complications.Conclusions: PEA for thyroid lesions is an effective and safe method. PEA should be the first option for the treatment of pure cystic and predominantly cystic nodules. PEA is a safe procedure that is easy to repeat and to be performed on an outpatient basis.