How to treat thyroid cysts?

Written by Chen Xie
Endocrinology
Updated on September 07, 2024
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Treatment of thyroid cysts generally does not require special treatment, just regular monitoring of thyroid ultrasound and thyroid function. Thyroid function must be monitored for thyroid cysts. When thyroid function is reduced, hormone replacement therapy is needed. When thyroid function is hyperactive, anti-thyroid treatment is needed. If the patient's thyroid function is normal, only regular monitoring of thyroid ultrasound and thyroid function is required to understand changes in the size of the cyst. However, if the cyst is large enough to cause symptoms such as breathing difficulties or carotid ischemia, surgical treatment is recommended in a timely manner. Currently, radiofrequency treatment is also a new treatment method, which can be considered as an alternative option, but it is not recommended.

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Symptoms of thyroid cysts

Regarding the symptoms of thyroid cysts, typically, patients with thyroid cysts do not experience any discomfort in the early stages. Often, a neck mass is incidentally discovered during a physical examination, and usually, there are no systemic clinical symptoms. Some patients may experience slight pain. Of course, if the cyst is large or there is bleeding within the cyst, it may lead to symptoms of compression, such as pain, difficulty swallowing, difficulty breathing, or hoarseness. Additionally, some thyroid cysts can affect thyroid function. For instance, if there is hyperthyroidism, symptoms may include heat intolerance, excessive sweating, and weight loss. Conversely, in long-term cases, patients may experience symptoms of hypothyroidism, such as cold intolerance, fatigue, constipation, and poor appetite.

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Which department should I go to for a thyroid cyst?

It is generally recommended to see a general surgeon, or an endocrinologist, as thyroid cysts are usually benign tumors that essentially remain stable in nature. Surgery is only considered when the cyst becomes very large and causes compressive symptoms, such as compressing the trachea leading to breathing difficulties, or compressing the esophagus causing difficulty swallowing. In such cases, you should consult a general surgeon. For a typical thyroid cyst, it is necessary to check thyroid function to ensure it is normal and to regularly review with ultrasound to monitor any changes in the cyst. If there is a sudden increase in size or significant compressive symptoms, it is advisable to seek surgical treatment from a surgeon.

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How should thyroid cysts be treated?

Thyroid cysts refer to fluid-containing sac-like formations found in the thyroid gland. For their treatment, thyroid cysts are a type of benign tumor of the thyroid. In imaging studies, if the nodule's diameter is less than one centimeter, it usually presents no clinical symptoms or signs. Regular follow-ups with thyroid ultrasonography and thyroid function tests are advised. If there is no trend of enlargement, continued observation without surgical intervention can be appropriate. However, if the nodule's diameter is greater than one centimeter, or if it is located on the surface of the thyroid, the local skin may show a protrusion or bulge, and the cyst may continue to grow, pressing on the trachea or even the esophagus, causing symptoms such as chest tightness, difficulty breathing, a feeling of swallowing, and obstruction. It is important to seek medical attention in a timely manner, undergo a fine needle aspiration biopsy if necessary, and surgical treatment may be required if needed.

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Will thyroid cysts recur after surgery?

Thyroid cysts refer to fluid-filled sac-like structures that occur in the thyroid gland. Typically, thyroid cysts do not exhibit any clinical symptoms. However, if they continue to grow, there is a risk of bleeding within the cyst. Therefore, when the cyst is larger than 3 centimeters, surgical treatment is often recommended. Generally, surgical removal is quite safe and reliable, and the prognosis after surgery is usually good with a low risk of recurrence. However, there is still a chance of recurrence, and if it recurs, surgery can be conducted again. Hence, thyroid cysts are relatively mild and benign lesions. If the cyst is smaller than 3 centimeters, alcohol sclerotherapy can also be performed.

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Can thyroid cysts become cancerous?

Thyroid cysts can potentially become cancerous. Initially, thyroid cysts may arise from various thyroid diseases such as nodular goiter, Hashimoto's disease, thyroid adenoma, and thyroid follicular cancer, which form through degeneration, liquefaction, and hemorrhage. They are one of the common diseases of the thyroid. In the population, at least 4% of people can feel thyroid nodules larger than one centimeter. Among these nodules, about 5% to 20% are cystic. Statistics show that even benign lesions causing cysts have a 4%-5% chance of becoming cancerous when the diameter of the individual exceeds 4 centimeters. Therefore, thyroid cysts can potentially become cancerous.