Ultrasound-guided sclerotherapy for benign non-thyroid cystic mass in the neck

Abstract

Surgical excision has traditionally been the treatment of choice for benign non-thyroid cystic neck masses, including lymphatic malformation, ranula, branchial cleft cyst, thyroglossal duct cyst, and parathyroid cyst. However, there is a tendency toward recurrence after surgery, and surgery may be accompanied by complications, including nerve injuries, vascular injuries, and scar formation. Ultrasound-guided sclerotherapy using various agents has been challenged and successfully applied as an alternative treatment for benign non-thyroid cystic neck masses. This report reviews the available sclerosing agents and describes the applications of sclerotherapy to the treatment of benign cystic masses in the neck.

Non-functional parathyroid cyst masquerading as a thyroid cyst: Report of two cases and review of the literature

“…This can be effective in leading to long-term cyst regression although reaccumulation of fluid remains a significant problem, as was illustrated in our case (Figure 1(a)). Sclerotherapy may be considered as an alternative approach to reduce recollection of cystic fluid [13]. This technique involves the injection of a sclerosing agent, such as ethanol, into the cyst which induces an inflammatory reaction, scarring, and obliteration of the cyst.…”

Efficacy and Safety of Ethanol Ablation for Branchial Cleft Cysts

“…Despite success rates of 50.0%-60.8% in BCCs treated with OK-432 (Table 3), 25.0%-41.7% of patients required an operation due to either partial or no response. [3][4][5][6][7]13 OK-432 induces a strong inflammatory reaction, including the activation of macrophages and production of cytokines so that fever and local pain develop as adverse effects, though no major complications have been reported. The potential for adverse effects related to the streptococcal preparation, such as post-rheumatic fever sequelae and glomerulonephritis, as well as penicillin-induced anaphylaxis, has also been suggested.…”

“…The former imaging was performed with 1 of 3 US systems: an iU22 ultrasound machine (Philips Healthcare, Best, the Netherlands), Acuson S2000 (Siemens, Erlangen, Germany), or an EUB-7500 HV (Hitachi Medical Systems, Tokyo, Japan). All 3 were equipped with a high-frequency linear probe (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The index cyst volume was calculated as V ϭ abc / 6, where V is the volume, a is the largest diameter, and b and c are the other 2 perpendicular diameters.…”

“…Therefore, minimally invasive treatment such as ultrasonography (US)-guided chemical ablation has been suggested as an alternative treatment for BCC. [2][3][4][5][6][7] Both chemical ablation with picibanil (OK-432) and ethanol ablation (EA) are widely used to treat cystic lesions of the neck and oral cavity, such as thyroid cyst, ranula, and lymphatic malformation, [8][9][10][11][12][13] but only a few studies have focused on the use of either treatment in BCCs. Since Fukumoto et al 2 initially used EA on 3 BCCs in 1994, several studies have reported success rates of roughly 60% in patients with BCC treated with OK-432.…”

Ok-432 (Picibanil) In the Treatment of Ranulas

“…Simple ranulas are limited to the base of the mouth and gradually show painless growth. On the contrary, plunging ranulas are localized under the mylohyoid muscle, grow towards the parapharyngeal area of the neck, and form a cystic swelling [2]. The ranulas seen most often in the second decade of life are of the simple type in women, while plunging ranulas are more common in males.…”