First session (first row of images):

Clinical presentation: A 38-year-old woman was referred for sclerotherapy of a thyroid cyst. The patient was on 26th gestational week of pregnancy. A cystic thyroid lesion was three-times aspirated in the previous 6 months. The last evacuation was performed three weeks prior the present visit but the cyst recurred within days. The patient had difficulties in swallowing.

Palpation: an elastic nodule in the right lobe and in the isthmus.

Functional state: euthyroidism with TSH 1.03 mIU/L.

Ultrasonography: The thyroid was echonormal. There was a large cystic lesion in the lower medial part of the right lobe.

We aspirated 36 mL watery fluid and thereafter injected 6 mL ethanol. The treatment caused no problem.

Additional tests were performed: wash-out thyroglobulin was 0 ng/dl while that of parathormone resulted in 1283 ng/L. Serum parathormone level was 34.1 ng/L (normal values 15-65). Serum calcium and phosphorus were in the normal range.

Second session (second row of images):

Clinical presentation: The patient had no complaints.

Palpation: no abnormality.

Ultrasonography: The cysts almost disappeared.

We administered 1 mL ethanol.

3 years after the last session (third row of images):

Clinical presentation: The patient had no complaints.

Palpation: no abnormality.

Ultrasonography: The thyroid was echonormal. We found a small minimally hypoechogenic area in the isthmic part of the right lobe. It corresponded to the previously treated large cyst.