Nine patients with 16 symptomatic nonneoplastic congenital hepatic
cysts were treated prospectively by ultrasonically guided percutaneous
minocycline hydrochloride injection, and the usefulness of this treatment was evaluated. Seven of the patients had multiple hepatic
cysts, and two
solitary cysts. All the patients were women, ranging in age from 36 to 81 years. After cystic fluid had been aspirated with a 21-gauge PTC needle,
minocycline hydrochloride was injected into all the
cysts. The
minocycline hydrochloride was dissolved in saline at a concentration of 200 mg in 9 ml, and mixed with 1 ml of 2%
mepivacaine hydrochloride. The total quantity of
minocycline hydrochloride injected varied from 100 mg to 1200 mg per hepatic
cyst, depending on its size. Total or subtotal regression of the
cysts was observed in all patients during follow-up periods ranging from 15 to 35 months. Seven patients became symptom-free, one showed symptom reduction, and one showed no change in symptoms. Minor side effects, eg, transient
abdominal pain, slight right
shoulder pain, and temperature elevation, were noted in three patients respectively. On the basis of these results, we conclude that ultrasonically guided percutaneous
minocycline hydrochloride injection is useful for the treatment of symptomatic hepatic
cysts.