Long‐term results of multiple minocycline hydrochloride injections for the treatment of symptomatic solitary hepatic cyst

Abstract

Multiple injections of MINO are safe, definitive treatments for symptomatic solitary hepatic cyst.

Repeated Minocycline Hydrochloride Injections for Symptomatic Polycystic Liver Disease

“…A number of treatments for symptomatic hepatic cyst have been developed . We have previously shown that minocycline hydrochloride (MINO) effectively promotes the regression of symptomatic simple hepatic cyst acutely [26,27] . In symptomatic PLD, radical treatment is difficult, with the exception of liver transplantation.…”

“…Both of these forms of PLD have an autosomal dominant pattern of inheritance [55] . There are various treatments for symptomatic hepatic cysts, such as cyst aspiration sclerotherapy [26,27,30,[35][36][37][38][39][40][41][42][43][44][45] , cyst fenestration (deroofing) [28,46] , liver resection [32][33][34]47] , hepatic arterial embolization [29] , and transplantation [31] . These treatments do not alter the natural course of the disease.…”

“…Among nonsurgical treatments, a 100% recurrence rate has been reported after cyst aspiration alone; an alternative method of treatment is thus required [65] . The instillation of various sclerosing agents has been used to obliterate symptomatic congenital hepatic cysts [26,27,30,[35][36][37][38][39][40][41][42][43][44][45] . Aspiration sclerotherapy involves cyst aspiration followed by the injection of a sclerosing agent, which destroys the epithelial cells lining the cyst cavity.…”

“…A low concentration of MINO (1 to 2 mg/mL) is usually injected intravenously. MINO injection has been used to treat renal cysts [66][67][68] , splenic cysts [69] , thyroid cysts [70] , and hepatic cysts [26,27,38,[41][42][43] . MINO 100 mg/mL was injected to treat thyroid cysts [70] , and MINO 10 mg/ mL [66] was instilled into renal cysts.…”

“…MINO 100 mg/mL was injected to treat thyroid cysts [70] , and MINO 10 mg/ mL [66] was instilled into renal cysts. Concentrations of MINO that have been used to manage hepatic cysts range from 5 to 50 mg/ mL [26,27,38,[41][42][43] . The efficacy of MINO injection is related to the extremely low pH of the tetracycline in solution, which destroys the mesothelial cells secreting the effusion, leading to involution of the cyst.…”