Attn: All who have used PEI for Thyroid Cysts....

[ChitChatNine]

If you've used Percutaneous Ethanol Injection (PEI) for thyroid cysts, we're trying to build a reference thread sharing your experiences with this treatment.  Please feel free to share your results and we'll put this thread into the Health Pages along with the excerpt from the Abstract Article cited below.

From what I've heard, this procedure is still not widely used.  Many patients are undergoing avoidable surgery when this procedure is used on benign cysts.  Let’s hope that PEI would provide relief for these who are wanted to get rid of unsightly or compressive cyst but cannot afford or does not want surgery.

________

For those not familiar with PEI here is an excerpt from an article.

"Simple aspiration of the fluid content of thyroid cysts is ineffective as thyroid cysts usually recur. Our study provides evidence that PEI is a safe, effective, and curative treatment for benign cystic thyroid nodules."

This technique is a simple interventional procedure performed under ultrasound guidance by inserting a special needle inside the thyroid cyst. After aspirating the fluid content of the cyst [using the syringe], the physician injects a small amount of 95% ethanol.

Compared with the traditional surgical treatment of large thyroid cysts, the advantages of PEI include avoidance of surgical risks, outpatient setting, no need for general or local anesthesia, brevity of the procedure (which can be completed in a few minutes), reduced cost, and preservation of normal thyroid tissue.

"Ethanol administration causes the formation of scar tissue and therefore it is usually a definitive cure, while simple cyst evacuation is not,"

source:
Medscape
Ethanol Ablation Safe, Effective for Thyroid Cystic Nodules
Laurie Barclay, MD

Endo 2003: Abstracts OR10-1, OR10-2. Presented June 19, 2003


Looking forward to hearing from those who have had this procedure!

C~

[Delena2]

I am really wanting to have this done but can't find a doctor in Washington who does this.
I have a painful cyst in the left thyroid.  My right was already removed.  

Does anyone know how I can find a doctor who does this?   What kind of doctor should I be looking for?

[boubou00]

I have a benign cyst on the right front that grew 4 times it size since last year.  I went to Dr. Azer (endo) in Beverly Hills.
He let me know that this procedure is not commonly done, he has sucessfully used this treatment many times.  He thought I was a good candidate because it was located in the front and easily accesible.
The Procedure:  I went in and Dr. looked at the cyst with the ultrasound.  He withdrew approx. 1.5 ccs of fluid and that will also go for biopsy.  He had hoped to get more out of the cyst.  He then injected the alcohol and got in 1.5 ccs but had hoped to get in 2.  It seems that maybe the cyst wasnt just a sac of fluid it may have been more dense than it appeared.
Results. My neck was sore and I used Ice the first night and the next day I have some mild bruises.
I will go back in one month to check and he expects it to scar and reduce to its max potential in 6 months.
I would much rather do this than have surgery, so I hope it works!!  Will post in a month.
Hope this helps.

[kirenee]

I am a 48 yr old woman, post-menopausal who is hypothyroid. I was diagnosed in 2002 and had a 2cm goiter they did a fine needle biopsy. It was not cancer, Put me on synthroid .25 it went down in size. I have been going to regular doctor since I had two fnas done. It has grown to the size of a lime now, blood levels show thryoid is fine. I have dry skin, hair, losing hair, tired, and sleepy. Doctor says I need a partial removal of thyroid. Checking to see if it is cancer with another fine needle biopsy first. I would like to have the ehtanol injection method done. Am I a canidate? Thanks Karen P.S. If not a canidate couldnt I just take double the amount of synthroid to see if it shrinks?

[nancybenoit]

I live in Canada but am willing to travel.
Where can I receive these treatments. I want to cancel my surgery date, but I want an alternative before I do because I've waited so long for this appointment.

Thank you,

Nancy

[pikapp44]

Can anyone recommend a doctor in Florida that does PEI?

[nalnk]

Can someone help me in finding a surgeon / dr. who performs this procedure.  I live in central new jersey.

[ChitChatNine]

Response by Dr. Mark Lupo - Endocrinologist on our Expert Forum:
by Mark Lupo, M.D.

http://www.medhelp.org/posts/show/704111

PEI can be very effective in the treatment of larger cysts that have one significant pocket of fluid (in contrast to multiple, small pockets of fluid) -- The cyst is drained then approx half of that volume in 95% ethanol is injected back into the cyst.  Risks include extravasation of the ethanol into the local tissues with possible damage to the nerve going to the vocal cords (usually temporary).  There are a few of us who perform these on a regular basis, but it is still not widely available.   In many cases, it can prevent the need for surgery.

PEI can be very effective in the treatment of larger cysts that have one significant pocket of fluid (in contrast to multiple, small pockets of fluid) -- The cyst is drained then approx half of that volume in 95% ethanol is injected back into the cyst.  Risks include extravasation of the ethanol into the local tissues with possible damage to the nerve going to the vocal cords (usually temporary).  There are a few of us who perform these on a regular basis, but it is still not widely available.   In many cases, it can prevent the need for surgery.







http://www.medhelp.org/posts/show/704111

[ChitChatNine]

PS .. I'm trying to get in to Dr. Lupo's expert forum to ask his opinion on this procedure.  If anybody is able to get in, just PM me or post below .. the forum has "reached the limit" for ?'s LOL and even though I'm a CL .. I keep trying to post over there like any other member :)

C~