Do thyroid cysts require surgery?

Written by Zhang Li
Endocrinology
Updated on September 09, 2024
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Thyroid cysts are relatively common in clinical practice. Whether surgery is necessary depends on two factors. On one hand, it depends on whether the cyst is malignant. If the ultrasound reveals small calcifications within the cyst, or other signs of malignancy, then a fine needle aspiration of the thyroid should be carried out for a pathological examination. If the cyst is confirmed to be malignant, surgery is generally recommended. However, if the examination indicates that the thyroid cyst is benign with a low malignancy level, surgery is usually not required. However, if the thyroid cyst is large, affects appearance, causes significant swallowing difficulties or hinders neck movement, surgery can also be considered.

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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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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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What should I do about a thyroid cyst?

What should I do if I have a thyroid cyst? First, we need to understand what a thyroid cyst is. A thyroid cyst refers to a fluid-filled sac found in the thyroid gland. Generally, patients with thyroid cysts do not show any clinical symptoms in the early stages. Some discover a lump accidentally, usually without systemic symptoms. Individual patients may exhibit symptoms such as hyperthyroidism, and some with a longer disease course can also experience hypothyroidism, such as fatigue, poor appetite, constipation, and edema. Therefore, when diagnosed with a thyroid cyst, it is crucial to determine whether the cyst is benign or malignant and whether it affects thyroid function. If it does impact function, symptomatic treatment is necessary. Of course, most thyroid cysts are benign and can be monitored over time.

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What should be paid attention to regarding thyroid cysts?

Thyroid cysts generally do not show obvious symptoms. When a cyst significantly enlarges or internal bleeding occurs, compressive symptoms or pain may appear. Thyroid cysts can lead to hyperthyroidism, and if persistent, may eventually cause hypothyroidism. Therefore, it is necessary to regularly monitor thyroid function to understand the status of thyroid activity. The treatment of thyroid cysts primarily involves distinguishing whether they are malignant. For thyroid cysts suspected to be malignant, surgical treatment is required. Generally, thyroid cysts are benign and only require regular observation and follow-up.

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Does thyroid cyst affect pregnancy?

Thyroid cysts generally do not affect pregnancy because they are merely morphological changes, meaning enlarged cystic nodules found in the thyroid. These nodules are typically fluid-filled and often non-functional, so they do not significantly impact pregnancy. However, since the thyroid can develop such cystic nodules or cysts, there might also be some functional manifestations. In other words, there could be both cysts and other thyroid function issues concurrently, which might affect pregnancy. Therefore, when thyroid issues are detected, it is necessary to undergo thyroid function tests before planning a pregnancy to determine whether it is safe to conceive and if there will be any impact on pregnancy.