Wednesday, May 21, 2008

PEI: What is PEI and why do I need to know about it, if I have a thyroid cyst, or parathyroid cyst, and have been told to have surgery?

Case Presentation:
50 Y/O Chinese male was told in Shanghai, that the only therapy for his recurrent thyroid cyst was surgery. A modern Chinese male hits the web to research this, before submitting for surgery. He found thyroid,com, and emailed me about coming to the USA for a consultation. He was euthyroid, on no medications, and had a 15 cc pure cyst.
The ultrasound guided FNA biopsy confirmed the cyst was indeed thyroid in nature, and the biopsy was negative for cancer. When he next visited the USA, under US guidance I
withdrew 15 cc of cyst fluid and re-injected 7.5 cc of medical grade ethanol. There was no pain or complications. He returned to see me 6 weeks later. The cyst was not visible anymore, and the ultrasound confirmed it was >99% ablated. There was a 1-2 mm residual seen on ultrasound.He had his wish come true to fix the cyst, but without major surgery, and hospitalization.

This PEI procedure can be used as primary treatment for non-functioning parathyroid cysts, and thyroglossal ducts that have recurred and failed surgery. It is mandatory to rule out cancer in mixed cysts of any nature before PEI is considered as a therapy option. It has another major use in the treatment of recurrent cancer lymph nodes in thyroid cancer patients,after a recurrence and prior neck explorations.

Good Luck,


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