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Review
. 2014 Apr;33(2):83-90.
doi: 10.14366/usg.13026. Epub 2014 Feb 26.

Ultrasound-guided sclerotherapy for benign non-thyroid cystic mass in the neck

Ji-Hoon Kim  1
Affiliations
Review

Ultrasound-guided sclerotherapy for benign non-thyroid cystic mass in the neck

Ji-Hoon Kim. Ultrasonography. 2014 Apr.

Abstract

Surgical excision has traditionally been the treatment of choice for benign non-thyroid cystic neck masses, including lymphatic malformation, ranula, branchial cleft cyst, thyroglossal duct cyst, and parathyroid cyst. However, there is a tendency toward recurrence after surgery, and surgery may be accompanied by complications, including nerve injuries, vascular injuries, and scar formation. Ultrasound-guided sclerotherapy using various agents has been challenged and successfully applied as an alternative treatment for benign non-thyroid cystic neck masses. This report reviews the available sclerosing agents and describes the applications of sclerotherapy to the treatment of benign cystic masses in the neck.

Keywords: Cysts; Neck; Picibanil; Sclerotherapy; Ultrasonography.

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Figures

Figure 1.
Figure 1.. A 54-year-old man with a macrocystic lymphatic malformation treated with ethanol.
A. Ultrasonography reveals a large cystic mass in the right supraclavicular area. B. After treatment with ethanol, the cystic mass decreased markedly, resulting in a small echogenic lesion (arrows).
Figure 2.
Figure 2.. A 17-year-old girl with a plunging-type ranula treated with OK-432.
A. Computed tomography reveals a lobulated cystic mass in the left submandibular space (arrows). B. Ultrasonography reveals an insinuating septated mass (arrows) that herniates from the sublingual space into the left submandibular space through the mylohyoid muscle (black arrowheads). The herniating tract (white arrowheads) between the sublingual space and the submandibular space is seen as an echogenic tubular structure. C. After three treatments with OK-432, the lesion disappeared completely.
Figure 3.
Figure 3.. A 52-year-old woman with a left tonsillar cancer.
Computed tomography reveals a cystic mass with septation (arrowheads) in left level II.
Figure 4.
Figure 4.. A 30-year-old woman with a thyroglossal duct cyst.
A. Computed tomography reveals a cystic mass (arrow) at the anterior and inferior aspects of the hyoid bone. B. Ultrasonography reveals a cystic mass. C. After the treatment with ethanol, the lesion decreased in size.
Figure 5.
Figure 5.. A 63-year-old woman with a parathyroid cyst.
Transverse (A) and sagittal (B) ultrasonography reveals a lobulated pure cystic mass (arrows) in the inferior aspect of the left thyroid gland. After treatment with ethanol, the lesion disappeared completely.
See this image and copyright information in PMC

References

    1. Kim MG, Kim SG, Lee JH, Eun YG, Yeo SG. The therapeutic effect of OK-432 (picibanil) sclerotherapy for benign neck cysts. Laryngoscope. 2008;118:2177–2181. - PubMed
    1. Colbert SD, Seager L, Haider F, Evans BT, Anand R, Brennan PA. Lymphatic malformations of the head and neck-current concepts in management. Br J Oral Maxillofac Surg. 2013;51:98–102. - PubMed
    1. Sung MW, Lee DW, Kim DY, Lee SJ, Hwang CH, Park SW, et al. Sclerotherapy with picibanil (OK-432) for congenital lymphatic malformation in the head and neck. Laryngoscope. 2001;111:1430–1433. - PubMed
    1. Roh JL, Kim HS. Primary treatment of pediatric plunging ranula with nonsurgical sclerotherapy using OK-432 (Picibanil) Int J Pediatr Otorhinolaryngol. 2008;72:1405–1410. - PubMed
    1. Rho MH, Kim DW, Kwon JS, Lee SW, Sung YS, Song YK, et al. OK-432 sclerotherapy of plunging ranula in 21 patients: it can be a substitute for surgery. AJNR Am J Neuroradiol. 2006;27:1090–1095. - PMC - PubMed

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