After an incident where the mother received a blow to the neck by her child, she began to experience pain and tenderness and marked swelling of her neck. She did not realize the trauma caused the swelling and was fearful of cancer, because it was rapid in onset and very large. She noted that the swelling deceased in size but was still painful. She had a large visible mass from across the examining room. The ultrasound confirmed a 5 cm cystic mass. The rest of the thyroid confirmed a diffuse goiter was present. Thyroid tests were normal. The ultrasound guided FNA produced 5.6 cc of bloody fluid. The attempt to biopsy the mass was unable to confirm an underlying cancer. She returned in 1 week. The mass was not visible and was decreased in size due to the decompression and fluid removal. The repeat US revealed a reduction of 60% in the size of the cyst. There was no pain or tenderness now. She was placed on thyroid hormone to suppress the goiter. If the cyst recurs, she will be a candidate for percutaneous ethanol injection, or PEI. This has replaced surgery as the primary therapy for non-cancerous recurrent cysts. There is an average 80% reduction in size with PEI.
If you have a recurrent cyst, please consider a visit to my center instead of a major surgical intervention for a minor cyst.
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