Thyroid nodules are prevalent especially in the advent of ultrasonographic evaluation. In patients with cystic nodules, compressive and cosmetic symptoms are of concern and these patients are usually sent for surgery to alleviate these concerns. Given an alternative which is minimally invasive, safe and effective, ultrasound-guided percutaneous fine needle aspiration may be offered to patients with cystic thyroid nodules.
OBJECTIVE: To determine the efficacy of percutaneous fine needle aspiration in the treatment of thyroid cystic nodules and factors that affect it.
METHODS: This is a retrospective cohort study reviewing the charts of patients with cystic thyroid nodule who underwent ultrasound-guided percutaneous fine needle aspiration in the Diabetes, Thyroid and Endocrine Center, St Luke's Medical Center Quezon City from November 2013 to December 2014. Ultrasonographic examinations were reviewed within the one year period after aspiration to determine recurrence.
RESULT: A final cohort of 92 charts were reviewed but only 69 patients were included in the study, majority of which were female. Sixty nine percent of the nodules were predominantly cystic while 30% were purely cystic. The mean pretreatment volume was 15.56ml ± 15.97ml (range: 2 to 75ml). The mean volume of aspirated fluid was 9.71ml ± 12.50ml (range: 0.2-64ml). The mean percent reduction was 77.25% ± 27.09% (range: 0 to 100%). Complete response, partial response and no response was seen in 32, 27, and 10 cases, respectively. Among the 69 thyroid cystic nodules aspirated, only 22 had repeat surveillance ultrasound within the one year observation period after aspiration. Of the 22 patients with repeat ultrasound, only 17 imaging findings were analyzed to determine long-term efficacy or recurrence. Among the 17 nodules analyzed, 10 nodules have re-accumulation of the cystic fluid with a recurrence rate of 17% (10 out of 59).