Percutaneous Sclerotherapy of Cystic Lesions

Abstract

With modern cross-sectional imaging techniques, cystic lesions are very common and usually incidental findings, especially if small. However, when cysts enlarge, become infected, bleed, or undergo torsion, they can be symptomatic, and percutaneous drainage can be effective in the management. When cysts recur after aspiration, which is often the case for hepatic and renal cysts, cyst sclerosis or surgical unroofing may be required. This article describes the indications for and technical aspects of percutaneous sclerotherapy of cystic lesions of multiple organ systems.

Keywords

interventional radiology - sclerotherapy - cysts - alcohol

• References

• 1 Lucey BC, Kuligowska E. Radiologic management of cysts in the abdomen and pelvis. AJR Am J Roentgenol 2006; 186 (2) 562-573
• 2 Saini S, Mueller PR, Ferrucci Jr JT, Simeone JF, Wittenberg J, Butch RJ. Percutaneous aspiration of hepatic cysts does not provide definitive therapy. AJR Am J Roentgenol 1983; 141 (3) 559-560
• 3 Holmberg G, Hietala SO. Treatment of simple renal cysts by percutaneous puncture and instillation of bismuth-phosphate. Scand J Urol Nephrol 1989; 23 (3) 207-212
• 4 Montalvo BM, Yrizarry JM, Casillas VJ , et al. Percutaneous sclerotherapy of lymphoceles related to renal transplantation. J Vasc Interv Radiol 1996; 7 (1) 117-123
• 5 Phelan M, Zajko A, Hrebinko RL. Preliminary results of percutaneous treatment of renal cysts with povidone-iodine sclerosis. Urology 1999; 53 (4) 816-817
• 6 Yoshida H, Onda M, Tajiri T , et al. Long-term results of multiple minocycline hydrochloride injections for the treatment of symptomatic hydrochloride injections for the treatment of symptomatic solitary hepatic cyst. J Gastroenterol Hepatol 2003; 18: 595-598
• 7 Kerlan Jr RK, LaBerge JM, Gordon RL, Ring EJ. Bleomycin sclerosis of pelvic lymphoceles. J Vasc Interv Radiol 1997; 8 (5) 885-887
• 8 Kim SH, Moon MW, Lee HJ, Sim JS, Kim SH, Ahn C. Renal cyst ablation with n-butyl cyanoacrylate and iodized oil in symptomatic patients with autosomal dominant polycystic kidney disease: preliminary report. Radiology 2003; 226 (2) 573-576
• 9 Demir E, Alan C, Kilciler M, Bedir S. Comparison of ethanol and sodium tetradecyl sulfate in the sclerotherapy of renal cyst. J Endourol 2007; 21 (8) 903-905
• 10 Egilmez H, Gok V, Oztoprak I , et al. Comparison of CT-guided sclerotherapy with using 95% ethanol and 20% hypertonic saline for managing simple renal cyst. Korean J Radiol 2007; 8 (6) 512-519
• 11 Yamamoto K, Sakaguchi H, Anai H , et al. Sclerotherapy for simple cysts with use of ethanolamine oleate: preliminary experience. Cardiovasc Intervent Radiol 2005; 28 (6) 751-755
• 12 Yoo KH, Lee SJ, Jeon SH. Simple renal cyst sclerotherapy with acetic acid: our 10-year experience. J Endourol 2008; 22 (11) 2559-2563
• 13 Kairaluoma MI, Leinonen A, Ståhlberg M, Päivänsalo M, Kiviniemi H, Siniluoto T. Percutaneous aspiration and alcohol sclerotherapy for symptomatic hepatic cysts. An alternative to surgical intervention. Ann Surg 1989; 210 (2) 208-215
• 14 vanSonnenberg E, Wroblicka JT, D'Agostino HB , et al. Symptomatic hepatic cysts: percutaneous drainage and sclerosis. Radiology 1994; 190 (2) 387-392
• 15 Moorthy K, Mihssin N, Houghton PWJ. The management of simple hepatic cysts: sclerotherapy or laparoscopic fenestration. Ann R Coll Surg Engl 2001; 83 (6) 409-414
• 16 Tikkakoski T, Mäkelä JT, Leinonen S , et al. Treatment of symptomatic congenital hepatic cysts with single-session percutaneous drainage and ethanol sclerosis: technique and outcome. J Vasc Interv Radiol 1996; 7 (2) 235-239
• 17 Larssen TB, Rosendahl K, Horn A, Jensen DK, Rørvik J. Single-session alcohol sclerotherapy in symptomatic benign hepatic cysts performed with a time of exposure to alcohol of 10 min: initial results. Eur Radiol 2003; 13 (12) 2627-2632
• 18 Yang CF, Liang HL, Pan HB , et al. Single-session prolonged alcohol-retention sclerotherapy for large hepatic cysts. AJR Am J Roentgenol 2006; 187 (4) 940-943
• 19 Kissane JM. The morphology of renal cystic disease. Perspect Nephrol Hypertens 1976; 4: 31-63
• 20 Israel GM, Bosniak MA. An update of the Bosniak renal cyst classification system. Urology 2005; 66 (3) 484-488
• 21 Lee J, Darcy M. Renal cysts and urinomas. Semin Intervent Radiol 2011; 28 (4) 380-391
• 22 Bean WJ. Renal cysts: treatment with alcohol. Radiology 1981; 138 (2) 329-331
• 23 Akinci D, Akhan O, Ozmen M , et al. Long-term results of single-session percutaneous drainage and ethanol sclerotherapy in simple renal cysts. Eur J Radiol 2005; 54 (2) 298-302
• 24 Lin YH, Pan HB, Liang HL , et al. Single-session alcohol-retention sclerotherapy for simple renal cysts: comparison of 2- and 4-hr retention techniques. AJR Am J Roentgenol 2005; 185 (4) 860-866
• 25 Madeb R, Feldman PA, Knopf J, Rub R, Erturk E, Yachia D. Povidone-iodine sclerotherapy is ineffective in the treatment of symptomatic renal cysts. J Endourol 2006; 20 (6) 402-404
• 26 Demir E, Alan C, Kilciler M, Bedir S. Comparison of ethanol and sodium tetradecyl sulfate in the sclerotherapy of renal cyst. J Endourol 2007; 21 (8) 903-905
• 27 Mori N. Clinical and experimental studies on the so-called lymphocyst which develops after radical hysterectomy in cancer of the uterine cervix. J Jpn Obstet Gynecol Soc 1955; 2 (2) 178-203
• 28 Sawhney R, D'Agostino HB, Zinck S , et al. Treatment of postoperative lymphoceles with percutaneous drainage and alcohol sclerotherapy. J Vasc Interv Radiol 1996; 7 (2) 241-245
• 29 Caliendo MV, Lee DE, Queiroz R, Waldman DL. Sclerotherapy with use of doxycycline after percutaneous drainage of postoperative lymphoceles. J Vasc Interv Radiol 2001; 12 (1) 73-77
• 30 Zuckerman DA, Yeager TD. Percutaneous ethanol sclerotherapy of postoperative lymphoceles. AJR Am J Roentgenol 1997; 169 (2) 433-437
• 31 Tasar M, Gulec B, Saglam M, Yavuz I, Bozlar U, Ugurel S. Posttransplant symptomatic lymphocele treatment with percutaneous drainage and ethanol sclerosis: long-term follow-up. Clin Imaging 2005; 29 (2) 109-116
• 32 Rozman Z, Thambidorai RR, Zaleha AM, Zakaria Z, Zulfiqar MA. Lymphangioma: is intralesional bleomycin sclerotherapy effective?. Biomed Imaging Interv J 2011; 7 (3) e18
• 33 Mathur NN, Rana I, Bothra R, Dhawan R, Kathuria G, Pradhan T. Bleomycin sclerotherapy in congenital lymphatic and vascular malformations of head and neck. Int J Pediatr Otorhinolaryngol 2005; 69 (1) 75-80
• 34 Watari H, Yamada H, Fujino T , et al. A case of intrauterine medical treatment for cystic hygroma. Eur J Obstet Gynecol Reprod Biol 1996; 70 (2) 201-203