picibanil and Thyroid-Nodule

Benign thyroid cysts have been successfully treated with nonoperative sclerotherapy. Although OK-432 is a safe and effective sclerosing agent used to treat benign cystic lesions, little is known about its effectiveness in thyroid cysts. This study tested the efficacy of OK-432 sclerotherapy for thyroid cysts.. This was a prospective cohort study of 45 consecutive patients with benign thyroid cysts, as assessed by ultrasound (US)-guided biopsy. After evacuation, about 50% of the aspirated fluid volume was replaced with saline solution containing 0.1 to 0.2 mg OK-432. Recurrences were treated by repeat treatments, to a maximum of 3. Outcome was cyst volume on US 6 months after the last treatment.. Median pretreatment cyst volume was 15 mL (range, 3.5-110). Of the 45 patients, 33 (73%) were cured, defined as a residual cyst volume <1 mL; 20 were cured after 1 treatment, 8 after 2 treatments, and 5 after 3 treatments. Of the 12 patients (27%) not cured, 7 had >50% of the original cyst volume and 5 had <50% volume reduction; 3 of these patients underwent hemithyroidectomy. Multivariate analysis showed that the chance of success decreased with the number of previous aspirations and with increased cyst volume (P < .015 each). Transient mild local pain and low-grade fever were observed in 26 (58%) and 19 (42%) patients, respectively, but there were no significant treatment-related complications.. Intracystic injection of OK-432 may be a safe and effective treatment for benign thyroid cysts.

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Child; Female; Follow-Up Studies; Humans; Injections, Intralesional; Male; Middle Aged; Picibanil; Prospective Studies; Sclerotherapy; Thyroid Nodule; Treatment Outcome; Ultrasonography; Young Adult

Sonography-guided OK-432 sclerotherapy is effective and safe, and offers a useful alternative treatment for benign thyroid cysts in selected patients.. To review the results of sonography guided OK-432 sclerotherapy for benign thyroid cysts.. The details of 20 patients who registered at our institute from December 2002 through August 2006, with recurrent cystic thyroid nodules after two or more aspirations, and who were cytologically negative for malignancy, were reviewed. All cases received OK-432 injections at a concentration of 0.05 mg/ml with sonography. When treatment results were unsatisfactory, the procedure was repeated up to three times at approximately 4 week intervals (mean number, 2.05).. Five of the 20 cases were excluded for various reasons. Eleven of the remaining 15 cases (73.3%) showed good responses (<10 mm in diameter), whereas the other 4 patients showed poor responses. All patients tolerated the therapy well, and no significant morbidity or complication occurred among patients treated by OK-432 sclerotherapy.

Topics: Adult; Antineoplastic Agents; Cysts; Female; Follow-Up Studies; Humans; Korea; Male; Middle Aged; Picibanil; Recurrence; Retreatment; Sclerotherapy; Thyroid Diseases; Thyroid Nodule; Treatment Outcome; Ultrasonography

We have adopted OK-432 as a sclerosing agent in the treatment of cystic predominant thyroid nodules and have analyzed our findings to assess the efficacy of intralesional instillation of OK-432. From 1992 through 1993, 48 patients with recurrent or progressive cystic thyroid nodules after 2 or 3 aspirations alone, and whom were cytologically negative for malignancy, were used for this study. The OK-432 solution was prepared by dissolving 0.1 mg of OK-432 in 2 ml of physiologic saline and it was instilled in the amount of 1/10-to-1/5 of the aspirated cystic fluid. A repeated course of therapy was given up to 3 times when sufficient resolution was not obtained 4-to-6 weeks after treatment. The mean number of treatment sessions per patient was 1.5. Throughout the follow-up period from 30-to-45 months (mean, 38 months), 32 (66.7%) patients experienced an almost complete disappearance (< 0.05 cm in diameter) of the cystic lesion, and 12 (25%) patients responded partially by having it decrease by more than half (> 0.5 cm in diameter) of the initial cyst size, and none of these patients required further treatment. The remaining 4 (8.3%) patients showed insufficient resolution despite 3 courses of therapy and 2 of these patients underwent thyroidectomy, in which the lesion proved benign in both cases. All of the patients tolerated the sclerotherapy well. No significant local complications attributed to this treatment were observed. However, a low-grade fever was observed in 26 (54.2%) patients for 2 to 5 days after instillation, which subsided with symptomatic treatment. On the basis of our experience, OK-432 sclerotherapy appears to be safe, simple and effective, and can be a useful alternative treatment for cystic thyroid nodules.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cysts; Female; Humans; Male; Middle Aged; Picibanil; Recurrence; Sclerotherapy; Thyroid Nodule