tetracycline and Thyroid-Diseases

Topics: Cosmic Radiation; Environmental Exposure; Female; Fetus; Food Contamination, Radioactive; Humans; Iodine Isotopes; Maternal-Fetal Exchange; Neoplasms; Nuclear Energy; Placenta; Pregnancy; Pregnancy Complications; Radiation Injuries; Radioactive Waste; Radiography; Radioisotope Renography; Radioisotopes; Radionuclide Imaging; Serum Albumin, Radio-Iodinated; Terminology as Topic; Tetracycline; Thyroid Diseases

In order to verify sclerotherapy efficiency in solitary thyroid cysts, needle aspiration of the cyst followed by instillation of tetracycline hydrochloride into the cyst cavity was performed in 110 patients; in thirty of these the aspirations was ultrasonically guided. A tight dressing on the neck was applied for 48 hours in order to maintain pressure on the cyst cavity. All patients were treated with L-T4 in TSH-suppressive doses. In a few patients (< 155), the tetracycline instillation caused local pain, lasting less than two hours. In no case, did cytological examination of the sediment of the aspirated fluid reveal any evidence of malignant cells. In 82 patients (84.54% of the 97 controlled patients), the last ultrasonic follow-up (performed at 3, 6, 9, 12 or 24 months) showed a decrease in lesion size. In particular, 16 patients (16.50%) had a complete cyst disappearance, 41 patients (42.17%) had a volume reduction of the cyst between 85 and 65%, and in 25 patients (25.77%) the reduction was more than 25%. In the remaining 15 patients (15.46%) a second treatment was performed, 3 of them also required a third treatment but in all these cases, the results seemed to be less satisfactory. The distinction in cyst size seemed to indicate that in the case of a large cyst (> 36 mm diameter), the treatment gives better results (92% success rate against 82% of the other patients). In conclusion, we are able to affirm that needle aspiration of the thyroid cyst with instillation of tetracycline hydrochloride is a simple, well tolerated and low cost technique.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Biopsy, Needle; Cysts; Female; Humans; Male; Middle Aged; Sclerotherapy; Tetracycline; Thyroid Diseases; Treatment Outcome

A dichotomy exists in the literature concerning the efficacy of sclerosing agent tetracycline hydrochloride for treatment of thyroid cysts. However, the studies vary in patient selection and none employed a statistical method for simultaneous analysis of multiple factors that might affect the outcome of therapy. We, therefore, studied the efficacy of percutaneous instillation of tetracycline for eradication of recurrent thyroid cysts, using a multivariate analysis. Thirty-seven patients with recurrent, cytologically benign thyroid cysts (not cured after 3 aspirations) were studied. Twenty-three patients were given tetracycline instillations [100 mg/ml, range (R): 1-4 ml]. The remainder underwent only repeated needle aspiration. They were followed for 33 +/- 12 (SD) months, R: 12-58 months. Cure was achieved in 21 out of 23 cases after tetracycline instillation within 2 +/- 1.7 months (R: 1-6 months) and in 12 out of 14 cases after aspiration alone within 9.9 +/- 11.3 months (R: 1-43 months, 4-10 aspirations). Multivariate survival analysis using the Cox proportional-hazards regression model demonstrated significantly shorter time interval before cure in the group with tetracycline instillation (p = 0.001). The volume, color or duration of cysts and levothyroxine (L-T4) treatment did not appear to influence the outcome of therapy. After initial cure by tetracycline instillation, 5 cases had relapse. Three were later cured by reinstillation of tetracycline or by repeated aspirations (R: 1-3 times). Complications of tetracycline instillation included brief episode of neck pain and development of a foreign body granuloma in a single patient. In conclusion, tetracycline instillation is a quick and effective procedure for treating recurrent thyroid cysts.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Cysts; Female; Humans; Male; Middle Aged; Multivariate Analysis; Sclerosis; Tetracycline; Thyroid Diseases; Thyroid Gland; Thyroxine

In a prospective study, 53 consecutive patients with solitary thyroid cysts were randomized to ultrasonically guided cyst aspiration and subsequent flushing with isotonic saline (n = 30) or tetracycline hydrochloride (n = 23). The patients were followed up clinically and ultrasonically 1, 3, 6, and 12 months after treatment. If the cyst recurred, a repeated treatment was offered. Cure was defined as the absence of any residual nodule and an ultrasonic cyst volume of less than 1 mL 12 months after the last treatment. During follow-up, two patients without recurrence after saline treatment and six patients without recurrence after tetracycline treatment developed solid cold nodules. Fourteen (47%) of 30 patients in the saline group and ten (43%) of 23 patients in the tetracycline group were cured (not statistically significant). Tetracycline does not seem to offer any advantage over isotonic saline in the treatment of thyroid cysts, and some of these patients still need thyroid surgery.

Topics: Cysts; Female; Follow-Up Studies; Humans; Isotonic Solutions; Male; Random Allocation; Recurrence; Sclerosis; Sodium Chloride; Tetracycline; Thyroid Diseases; Thyroid Gland; Ultrasonography

Topics: Cytoplasm; Female; Humans; Lysosomes; Microscopy, Electron; Middle Aged; Pigmentation; Syndrome; Tetracycline; Thyroid Diseases; Thyroid Gland

Fine needle biopsy (FNB) has been used as a therapeutic method in different nodular lesions of the thyroid. Between 1989-1995, 295 subjects with thyroid cysts, 235 women and 60 men have been treated by FNB. The treatment of cysts was performed by: one or multiple aspirations in 207 cases, sclerosis by injection with tetracycline in 77 cases and by ethanol washing in 11 cases. 263 (89.11%) cases have been cured and we have lost track of 32 cases in the survey. Of the 207 cases treated by aspiration, 177 (86.5%) have been cured after one or more aspirations. Of the 77 cases treated by injections with tetracycline, 75 (97.26%) displayed sclerosis after one or more injections. All 11 cases treated by ethanol washing method displayed sclerosis. Between 1993-1995 we used percutaneous ethanol injection (PE1) in 6 cases, as an alternative to the classic treatment, in order to induce necrosis of toxic adenoma. After 1 to 9 injections all cases were cured, with the appearance of the entire image of the gland on the scintigram. In 4 cases of cold nodules with benign cytology PEI, induced a significant decrease of volume appreciated by sonography.

Topics: Adenoma; Administration, Cutaneous; Adolescent; Adult; Aged; Biopsy, Needle; Child; Cysts; Ethanol; Female; Humans; Male; Middle Aged; Tetracycline; Thyroid Diseases; Thyroid Neoplasms; Thyroid Nodule

We analyzed the effects of tetracycline hydrochloride or minocycline hydrochloride sclerotherapy on 66 recurrent thyroid cysts. All were hemorrhagic lesions except one serous cyst; cytologic study showed all were benign. On average, three treatments were given until resolution or the patient became unavailable for follow-up. The cumulative frequency of cyst disappearance was 33%, 45%, 52%, and 59% after 1, 2, 3, and 4 treatments. Five additional patients had cyst resolution after six to 19 treatments, and the serous lesion did not resolve. Cysts requiring more than two treatments were larger at presentation than those resolving after one or two treatments. Side effects in 179 treatments were local pain lasting ten to 20 minutes in 4.5%, radiated pain lasting one to two hours in 4.5%, fatigue lasting one to two days in 3.9%, and a febrile sensation lasting one to two days in 2.8%. Hemorrhagic thyroid cysts can usually be cured by repeated tetracycline or minocycline sclerotherapy with tolerable side effects.

Topics: Cysts; Female; Hemorrhage; Humans; Male; Middle Aged; Minocycline; Recurrence; Sclerosing Solutions; Suction; Tetracycline; Tetracyclines; Thyroid Diseases

Topics: Adolescent; Adult; Aged; Cysts; Female; Humans; Injections; Male; Middle Aged; Recurrence; Sclerosing Solutions; Suction; Tetracycline; Thyroid Diseases

Of 770 hypofunctioning thyroid nodules subjected to needle biopsy since 1977, the fluid of 172 cysts (22%) was aspirated. The fluid, cytologically examined, showed no evidence of carcinoma except in three instances: papillary carcinomas that were subsequently treated surgically. Of the cystic lesions, 19 (11%) recurred and were treated by reaspiration and the instillation of tetracycline hydrochloride into the cyst cavity. In all but one instance this resulted in obliteration of the cysts (95%). This is a considerably higher rate of success than that reported from aspiration alone (40% to 85%). The follow-up period ranged from 1 to 42 months, with no recurrence or subsequent development of a thyroid nodule in these patients. The one recurrent cyst was reaspirated and reinstilled a second time, which resulted in great reduction in size. Not considered for this procedure were patients in whom the cytologic condition of the fluid was abnormal or indicative of a malignancy. Also excluded were those in whom there was incomplete decompression of the cyst, manifested by a persistent nodule. No patients had a history of head or neck irradiation or cervical lymphadenopathy, both contraindications for this procedure. No patients had grossly bloody aspirates. Recurrence of thyroid cysts after aspiration was not thought to be, in itself, a criterion for surgical selection. The effective use of tetracycline hydrochloride as a sclerosing agent in the treatment of malignant pleural effusions is well documented. Its action in producing symphysis is thought to be related to its low pH (2.0). This procedure is safe, simple, cost effective, and well tolerated by patients. It obviates the need for excision in patients who fulfill the aforementioned criteria.

Topics: Administration, Cutaneous; Cysts; Humans; Sclerosing Solutions; Tetracycline; Thyroid Diseases

Topics: Cysts; Humans; Recurrence; Tetracycline; Thyroid Diseases

Topics: Cysts; Female; Humans; Pain; Sclerosing Solutions; Tetracycline; Thyroid Diseases

Ten patients, 5 with recurrent pure cystic and 5 with recurrent mixed cystic-solid thyroid nodules, were studied. When repeated needle aspirations failed to decrease reaccumulation of fluid, tetracycline was injected directly into the cysts. As a result, all the pure cysts resolved completely, and four of the five mixed cystic-solid nodules diminished in size and fluid did not reaccumulate. Follow-up ranged from 12 to 20 months (mean 15 months). The procedure was generally well tolerated. It is concluded that instillation of tetracycline into both recurrent pure cystic and mixed cystic-solid thyroid lesions is a simple, safe and effective treatment.

Topics: Adolescent; Adult; Aged; Cysts; Female; Follow-Up Studies; Humans; Injections; Male; Middle Aged; Recurrence; Suction; Tetracycline; Thyroid Diseases

Topics: Cysts; Humans; Sodium Tetradecyl Sulfate; Tetracycline; Thyroid Diseases

Nine patients with recurrent purely cystic thyroid nodules after one or two previous cyst aspirations were treated with repeat cyst aspiration and instillation of intracystic tetracycline hydrochloride. All but two of the patients' cysts resolved completely and have not recurred after a follow-up period of 12 to 50 months (mean = 40). The remaining patients had a partial response that left them with clinically insignificant lesions. The procedure was well tolerated and obviated the need for further therapy in all patients. Cyst aspiration and tetracycline instillation is a safe and effective treatment of recurrent purely cystic thyroid nodules that eliminates the need for surgical excision.

Topics: Adult; Cysts; Female; Humans; Male; Middle Aged; Recurrence; Sclerosing Solutions; Suction; Tetracycline; Thyroid Diseases; Ultrasonography

Topics: Adolescent; Cysts; Humans; Male; Sclerosing Solutions; Tetracycline; Thyroid Diseases

Topics: Abscess; Adolescent; Adult; Animals; Bile; Escherichia coli; Female; Humans; Kidney; Klebsiella; Liver; Lung; Male; Microbial Sensitivity Tests; Middle Aged; Myocardium; Rats; Skin Diseases; Spleen; Staphylococcus; Tetracycline; Thyroid Diseases; Thyroid Gland; Wound Infection