Treatment for Symptomatic Hepatic Cysts by Ultrasonically-guided Intracystic Injection of Minocycline Hydrochloride
神野 健二1, 新免 寛治1, 藤岡 真一1, 和田 俊裕1, 兵頭 一之介1, 棚田 稔2, 岡田 良雄3
Kenji JINNO1, Hiroharu SHINMEN1, Shinichi FUJIOKA1, Toshihiro WADA1, Ichinosuke HYOUDOU1, Minoru TANADA2, Yoshio OKADA3
1国立病院四国がんセンター内科, 2国立病院四国がんセンター外科, 3岡山県立短期大学栄養科
1Department of Internal Medicine Shikoku Cancer Center Hospital, 2Department of Surgery Shikoku Cancer Center Hospital, 3Okayama Prefectural Junior College
Hepatic Cyst, Minocycline Injection, Ultrasonography
The authors reported on two patients with simple hepatic cysts treated with an ultrasonically-guided injection of minocycline hydrochrolide dissolved in physiologic saline. Case 1 was a 59-year-old woman. She had full sensation in the abdomen with some cysts scattered in the liver, the largest one having a diameter of 10 cm. This huge cyst was treated with a direct injection of minocycline hydrochloride after drainage of as much intracystic fluid as possible. This procedure was performed with one puncture by a 21 G fine needle without the use of a continuous drainage catheter. After the teatment, the structure of multiple, thin septa was ultrasonogrphically formed in the cyst, the size of which was greatly decreased with the resultant disappearence of symptoms. Case 2 was a 52-year-old woman. She had been treated for hypertension with polycystic disease of the liver and kidneys. As abdominal fullness and palpitation had appeared with hepatomegaly, she was treated using the same method as Case 1. Minocycline solutions were instilled into 3 to 4 cysts at one time. The volume of the instilled minocycline solution was less than that in Case 1, which was regulated in proportion to that of the drained cystic fluids. As marked eosinophilia was seen in peripheral blood after 3 treatments, this procedure was stopped. The treated cysts decreased in size and symptoms were improved. Eosinophilia gradually disappeared after discontinuance of minocycline therapy. The authors have indicated in this article that minocycline injection therapy for symptomatic hepatic cyst is very useful and attention should be paid to such systemic complications as eosinophilia.