This protocol is indicated for patients with a benign thyroid nodule that is pure or dominantly cystic in composition and is causing local compression symptoms. The cystic character of the lesion and the presence of compressive symptoms together define the patient population and inform the selection of the appropriate intervention.
For this presentation, the evidence supports a minimally invasive ablation-based procedure directed at the cystic component as the recommended first-line treatment. The full procedural criteria, technique specifics, and clinical decision pathway are detailed in the structured protocol.
The primary objectives are a sustained, long-lasting reduction in nodule volume and meaningful relief of local compression symptoms, with durability assessed over a multi-year horizon.
DOI: 10.1530/ETJ-23-0067
Consider EA as the first-line treatment for pure, or dominantly cystic, thyroid lesions
EA is preferred as an effective, safe, and inexpensive treatment for cystic (or predominantly cystic) symptomatic thyroid nodules while TA procedures, due to their geometric and predictable volume of tissue destruction, are the first-line treatment for solid thyroid lesions.
MITs include ethanol ablation (EA), based on the direct injection of ethanol into a cystic cavity, and TA techniques, which use various energy sources: laser, radiofrequency, microwaves, or high-intensity focused ultrasound.
MITs result in a relevant and long-lasting decrease of nodule volume (57–77% at 5 years) that is paralleled by improvement of local symptoms and disease-related quality of life.
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