Clinical presentation: A 63-year-old man was referred for evaluation of a repeatedly recurring thyroid cyst. We have evacuated the nodule three times. We advised sclerotherapy instead of surgery.

Palpation: an elastic nodule in the right lobe.

Functional state: euthyroidism with TSH 1.85 mIU/L.

Ultrasonography: The thyroid was echonormal. There was a cystic nodule in the center of the right lobe and a hyperechogenic smaller lesion dorsal to it.

Aspiration cytology was performed and resulted in a benign colloid goiter.

First trial of sclerotherapy (first row of images): On the first occasion we completely evacuated the cyst which hindered to locate the needle to alcohol injection.

Sclerotherapy (second and third rows of images): One week after unsuccessful attempt, the cyst had refilled. Three sessions of sclerotherapy were performed. We demonstrate the first and last sessions.

Follow-up examinations (fifth and sixth row of images): We present the images of the 6-week and the 1-year follow-up. The nodule became less than 0.5% of the original volume and remained unchanged within the next 6 years.

Comment: We have to avoid complete evacuation of a cyst if the solid part is negligent in order to target successfully the lesion during alcohol injection. It is worth comparing the first and the second videos.