Patients should be assessed for suitability by a doctor experienced in the technique before being offered alcohol ablation.
Ultrasound is the key investigation in assessing suitability. Cystic (fluid filled) nodules that are either entirely fluid or predominantly fluid (generally at least 80% fluid) are considered ideal for alcohol ablation. The nodule being treated should always have benign (non-cancerous) ultrasound features and there should be no concerning features when the fluid or the solid area of a mainly fluid filled nodule is sent for analysis (cytology testing).
Cysts that do not cause any symptoms or cosmetic issues do not require treatment. In addition it is always worth attempting simple aspiration of the fluid without ethanol injection to see if the nodule shrinks down, but we know the recurrence rate is high. As many as 80% to 90% of cysts will recur after aspiration alone.
