Which is more serious, thyroid cysts or nodules?

Written by Zhao Xin Lan
Endocrinology
Updated on January 10, 2025
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Thyroid cysts are generally benign lesions without significant clinical symptoms. When the cysts are larger, they may cause local compressive symptoms but generally do not develop into cancer.

Thyroid nodules can be benign or malignant; primarily, an assessment of the nodule is conducted to determine its nature. If the nodule is nonfunctional and benign, the condition is usually minor. If the nodule is functional, such as a hyperfunctioning adenoma, it can have a more significant impact on the body. If ultrasound evaluation of the nodule leans towards malignancy, the severity of the nodule is considered greater, and surgical treatment is needed.

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Written by Li Lang Bo
Endocrinology
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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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Written by Chen Xie
Endocrinology
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Do thyroid cysts require surgery?

Thyroid cysts are benign nodules that generally only require follow-up observation. It is recommended to have a re-examination every 6 to 12 months, including thyroid ultrasound and thyroid function tests, to monitor the status of the cyst. If the cyst is large and affects breathing or even swallowing, cyst aspiration drainage can be performed, and nowadays radiofrequency ablation surgery is also an option. However, if the thyroid cyst shows signs of malignancy, a puncture for cytological examination is necessary to determine its benign or malignant nature. If it is malignant, thyroid cancer removal surgery is needed. Therefore, not all thyroid cysts require surgical treatment; it depends on the specific situation.

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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 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 Yang Li
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Is a grade two thyroid cyst serious?

Thyroid cysts at Grade 2A are generally not very serious. If we consider supporting points for severity in the thyroid, finding one example is considered as first-level evidence, while finding one plus another one counts as second-level evidence. Generally speaking, once it reaches Grade 4A and above, attention needs to be paid as it suggests a malignancy, indicating a higher possibility of malignancy. If it’s below 4A, at Grade 3 and below, it typically suggests a greater likelihood of benign lesions. In such cases, it is recommended to follow up dynamically and definitely conduct an ultrasonic contrast examination.