Treatment of Multinodular Goiter with Pure or Predominantly Cystic Benign Symptomatic Thyroid Lesion

This protocol applies to patients with multinodular goiter whose presenting nodule is a pure or predominantly cystic thyroid lesion that has been confirmed as benign and is causing local symptoms. This specific morphology — cystic or dominantly cystic — defines a distinct management pathway with well-characterised outcomes.

The patient has a pure or predominantly cystic, benign, symptomatic thyroid lesion. The cystic nature of the nodule is the key feature guiding the choice of first-line intervention, distinguishing this group from solid or mixed thyroid lesions.

First-line management involves ethanol ablation (EA) — a minimally invasive approach that targets the lesion directly. The full clinical criteria, procedural protocol, and follow-up algorithm are available in the complete evidence-based regimen.

Only a partial summary is shown here. The complete protocol covers eligibility, procedural steps, and post-procedural management.

The primary objectives are a relevant and long-lasting reduction in nodule volume (57–77% at 5 years) alongside improvement of local symptoms.