What causes thyroid cysts?

Written by Zhang Li
Endocrinology
Updated on September 15, 2024
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Thyroid cysts currently have no definitive cause identified. Previously, most believed they were possibly related to iodine deficiency, as such deficiency leads to thyroid hyperplasia and an increase in thyroid cysts. However, it was later discovered that in some high-iodine coastal areas, the incidence of thyroid cysts remains high. This suggests that variations in iodine levels, such as switches from low to high iodine or from high to low iodine, can also lead to the occurrence of thyroid cysts. Additionally, it is currently believed that there might be some connection with radiation and the use of mobile phones and computers, but there is no definitive conclusion. Regardless, once thyroid cysts occur, it is important on one hand to eliminate the possibility of malignant features, ruling out thyroid cancer, and on the other hand to ensure thorough thyroid function tests to understand if there are any abnormalities in function and whether treatment is needed.

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Written by Chen Xie
Endocrinology
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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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Written by Lin Xiang Dong
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How to treat thyroid cysts?

Thyroid cysts refer to fluid-filled sacs found in the thyroid, generally round in shape and varying in size, with no significant clinical symptoms. They can appear as a single nodule or multiple nodules. Typically, when thyroid cysts are detected, high-resolution thyroid ultrasonography can be used to observe their ultrasonographic appearance. Thyroid cysts are generally considered benign thyroid nodules and usually do not require treatment. Regular follow-up with thyroid ultrasound is sufficient. If the thyroid cyst is too large and causes compressive symptoms, such as difficulty in breathing or swallowing, hoarseness, etc., surgical removal can be considered.

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Written by Zhang Li
Endocrinology
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Differences between Thyroid Cysts and Nodules

Thyroid cysts and thyroid nodules are different. Generally, thyroid nodules are classified into solid nodules, mixed nodules, and cystic nodules. Most thyroid cysts refer to cystic nodules of the thyroid, meaning that the nodules primarily contain fluid components. Usually, these thyroid cysts are nonfunctional. That is, they contain some fluid, which could be exudate or bloody fluid, but these fluids generally do not cause hormonal level changes. Nodules, on the other hand, often involve functional changes; they can be nodules that produce thyroid hormones or could be cancerous nodules. Therefore, in these respects, thyroid cysts and nodules are different.

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Written by Zhang Li
Endocrinology
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Do thyroid cysts require surgery?

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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Written by Zhao Xin Lan
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Can thyroid cysts be treated with minimally invasive surgery?

When the cyst is smaller than 5cm, minimally invasive treatment can be used. Thyroid cysts are generally benign lesions and rarely become malignant. A thyroid cyst refers to a fluid-containing cystic structure in the thyroid, commonly known as a blister. This blister can be large or small, and is usually asymptomatic when small. For its treatment, when the cyst is smaller than 5cm, a minimally invasive procedure involving fine needle aspiration can be performed to withdraw fluid from the cyst, followed by the injection of anhydrous alcohol to close off the cyst cavity and prevent recurrence. However, if the cyst is larger than 5cm, surgical treatment is recommended for complete removal.