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Peer-reviewedCC BY-NC 4.0Diagnostic and Interventional Radiology

Safety and efficacy of combined ethanol and bleomycin sclerotherapy via percutaneous pigtail catheter for benign cervical cystic lesions: a single-center retrospective study

  • Sang Lim Choi1
  • Woosun Choi2
  • Byung Kook Kwak2
  • Jinyoung Choi2
  1. 1Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Department of Radiology, Gwangmyeong, Republic of Korea
  2. 2Chung-Ang University Hospital, Chung-Ang University College of Medicine, Department of Radiology, Seoul, Republic of Korea
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Abstract

PURPOSE: To evaluate the safety and efficacy of combined ethanol lavage and bleomycin sclerotherapy administered via a percutaneous pigtail catheter for the treatment of benign cervical cystic lesions.

METHODS: This retrospective study included 29 patients (mean age, 30 years; range, 4–60 years; male-to-female ratio, 16:13) who underwent bleomycin sclerotherapy following ethanol lavage via a pigtail catheter for benign cervical cystic lesions, including branchial cleft cysts, ranulas, thyroglossal duct cysts, lymphatic malformations, and epidermoid cysts, between March 2009 and September 2022. To explore potential predictors of treatment response, clinical diagnosis, baseline cyst size, and the total volume of injected sclerosant were evaluated. Statistical analyses included the paired t-test, chi-square test, and Mann–Whitney U test.

RESULTS: All patients were followed up for a mean duration of 18.2 months (range, 3–72 months) after the final treatment session. Complete cyst resolution was achieved in 17 of the 29 patients (59%), 8 patients (27%) demonstrated a volume reduction greater than 75%, and 2 patients (7%) exhibited a reduction of less than 75%; recurrence occurred in 2 patients (7%) despite repeated sclerotherapy. There were no significant differences between responders and nonresponders with respect to clinical diagnosis, baseline cyst volume, or total sclerosant dose. Minor procedure-related complications occurred in three patients (10.34%); no major complications were observed.

CONCLUSION: Combined ethanol lavage and bleomycin sclerotherapy administered via a percutaneous pigtail catheter is a safe and feasible treatment option for benign cervical cystic lesions.

CLINICAL SIGNIFICANCE: Combined ethanol and bleomycin sclerotherapy represents a safe, minimally invasive treatment option for benign cervical cystic lesions in routine clinical practice, with favorable outcomes and potential to reduce the need for surgical intervention.

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Cite

BibTeXRIS
BibTeX
@article{choi2026safety,
  title = {{Safety and efficacy of combined ethanol and bleomycin sclerotherapy via percutaneous pigtail catheter for benign cervical cystic lesions: a single-center retrospective study}},
  author = {Sang Lim Choi and Woosun Choi and Byung Kook Kwak and Jinyoung Choi},
  journal = {Diagnostic and Interventional Radiology},
  year = {2026},
  month = nov,
  doi = {10.4274/dir.2026.263802},
  url = {https://doi.org/10.4274/dir.2026.263802},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Safety and efficacy of combined ethanol and bleomycin sclerotherapy via percutaneous pigtail catheter for benign cervical cystic lesions: a single-center retrospective study
AU  - Sang Lim Choi
AU  - Woosun Choi
AU  - Byung Kook Kwak
AU  - Jinyoung Choi
PY  - 2026
DA  - 2026/11/02
JO  - Diagnostic and Interventional Radiology
DO  - 10.4274/dir.2026.263802
UR  - https://doi.org/10.4274/dir.2026.263802
AB  - PURPOSE: To evaluate the safety and efficacy of combined ethanol lavage and bleomycin sclerotherapy administered via a percutaneous pigtail catheter for the treatment of benign cervical cystic lesions.  METHODS: This retrospective study included 29 patients (mean age, 30 years; range, 4–60 years; male-to-female ratio, 16:13) who underwent bleomycin sclerotherapy following ethanol lavage via a pigtail catheter for benign cervical cystic lesions, including branchial cleft cysts, ranulas, thyroglossal duct cysts, lymphatic malformations, and epidermoid cysts, between March 2009 and September 2022. To explore potential predictors of treatment response, clinical diagnosis, baseline cyst size, and the total volume of injected sclerosant were evaluated. Statistical analyses included the paired t-test, chi-square test, and Mann–Whitney U test.  RESULTS: All patients were followed up for a mean duration of 18.2 months (range, 3–72 months) after the final treatment session. Complete cyst resolution was achieved in 17 of the 29 patients (59%), 8 patients (27%) demonstrated a volume reduction greater than 75%, and 2 patients (7%) exhibited a reduction of less than 75%; recurrence occurred in 2 patients (7%) despite repeated sclerotherapy. There were no significant differences between responders and nonresponders with respect to clinical diagnosis, baseline cyst volume, or total sclerosant dose. Minor procedure-related complications occurred in three patients (10.34%); no major complications were observed.  CONCLUSION: Combined ethanol lavage and bleomycin sclerotherapy administered via a percutaneous pigtail catheter is a safe and feasible treatment option for benign cervical cystic lesions.  CLINICAL SIGNIFICANCE: Combined ethanol and bleomycin sclerotherapy represents a safe, minimally invasive treatment option for benign cervical cystic lesions in routine clinical practice, with favorable outcomes and potential to reduce the need for surgical intervention.
SN  - 1305-3825
SN  - 1305-3612
ER  -