Abstract To the Editor. —In a previous issue of the Archives, Treece et al1 reported the successful use of tetracycline hydrochloride for sclerosis of recurrent thyroid cysts with uniformly successful results.1 One of us wrote an accompanying editorial.2 Subsequently, it has been reported3 that the first known use of an agent (tincture of iodine) to sclerose a thyroid cyst was in 1861.4We have since used tetracycline for thyroid cyst sclerosis with salutary results in approximately 20 patients. However, on two occasions, we have each noted a patient who experienced extreme pain almost immediately in the area of injection that was relieved only by the administration of intravenous morphine sulfate or intramuscular meperidine hydrochloride. One patient had had several aspirations performed elsewhere with fluid reaccumulation. After she experienced the pain, she was examined almost immediately by ultrasound, which showed no residual cyst. Presumably, the tetracycline extravasated References 1. Treece GL, Georgitis WJ, Hofeldt FD: Resolution of recurrent thyroid cysts with tetracycline instillation. Arch Intern Med 1983;143: 2285-2287.Crossref 2. Ryan WG: Needling the thyroid (and thyroid surgeons?). Arch Intern Med 1983;143:2249.Crossref 3. Kessler RK, Kessler WG, Constantine J, et al: Sclerosis of thyroid cysts. Arch Intern Med 1984;144:1693-1697.Crossref 4. Cyst in the thyroid gland cured by injection of tincture of iodine—under the care of Mr Thomas Bryant. Lancet 1861;1:331. 5. Sykes D: The solitary thyroid nodule. Br J Surg 1981;68:510-512.Crossref 6. Goodman AG, Goodman LS, Gilman A (eds): The Pharmacological Basis of Therapeutics , ed 6. New York, Macmillan Publishing Co Inc, 1980, p 96.
Archives of Internal Medicine – American Medical Association
Published: Jan 1, 1986
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