Can thyroid cysts become cancerous?

Written by Luo Juan
Endocrinology
Updated on March 20, 2025
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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.

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Written by Chen Xie
Endocrinology
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Foods to avoid with thyroid cysts

For patients with thyroid cysts, it is necessary to first understand the patient's thyroid function, whether it is normal, overactive, or underactive. For patients with thyroid cysts who also have hyperthyroidism, a diet avoiding iodine is still necessary, as excessive iodine intake can significantly affect their hyperthyroid condition, therefore they need to consume iodine-free food. However, for patients with normal thyroid function or those with hypothyroidism, a normal diet is appropriate, and there is no need to avoid iodine. It is also recommended that they avoid smoking and alcohol in their daily life.

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Written by Yang Li
Endocrinology
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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.

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Written by Zhang Li
Endocrinology
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Do thyroid cysts need treatment?

Thyroid cysts generally do not require special treatment, as most thyroid cysts are quite small, and even larger ones usually do not cause significant clinical symptoms. However, treatment may be necessary in some cases, such as when a thyroid cyst becomes large enough to cause compressive symptoms, leading to difficulty breathing or swallowing, in which case puncture or surgery might be considered. On the other hand, if a thyroid cyst is accompanied by abnormalities in thyroid function, it is important to assess whether there is hyperthyroidism or hypothyroidism and treat according to the specific functional state. Additionally, in a small number of cases where a thyroid cyst may have a tendency to worsen, a puncture biopsy is needed to make a diagnosis, and if confirmed, surgery and appropriate treatment should be carried out.

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Written by Luo Han Ying
Endocrinology
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The difference between thyroid cysts and nodules

Thyroid cysts are a benign change in the thyroid, and are generally classified as first or second level in clinical analysis. Thyroid nodules may be solid or may have mixed echogenicity. The biggest difference between a thyroid nodule and a cyst is their composition: cysts usually contain fluid, whereas nodules may contain other substances. Secondly, the vast majority of cysts are benign, classified as sub-level. Nodules, however, may potentially be malignant, and are classified as third, fourth, or even fifth level. If it is a thyroid cyst, there is no need for excessive worry. If it is a thyroid nodule, it is crucial to complete an ultrasound classification and then schedule regular follow-up exams.

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Written by Zhao Xin Lan
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Which is more serious, thyroid cysts or nodules?

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.