Thyroid cyst


What causes thyroid cysts?
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.


Are thyroid cysts contagious?
Thyroid cysts are not contagious. They are fluid-filled sacs within the thyroid gland, usually presenting as a single nodule, although in some cases multiple nodules can occur. Typically, thyroid cysts are asymptomatic unless the cyst becomes large or bleeds internally. In such cases, symptoms such as pain, difficulty swallowing, breathing difficulties, and a hoarse voice may occur. Thyroid cysts are considered a local endemic disease primarily caused by iodine deficiency, leading to thyroid hyperplasia and enlargement. Thyroid cysts represent a degenerative change. Therefore, thyroid cysts are not contagious.


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.


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.


How to treat thyroid cysts?
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.


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.


What are the symptoms of thyroid cysts?
Thyroid cysts generally refer to a cystic mass found in the thyroid, typically containing a mixture of fluid or semi-solid fluid. The mass usually has clear boundaries and is painless. It can move up and down with swallowing, which distinguishes it from some subcutaneous nodules. Thyroid cysts generally do not show obvious symptoms or clinical signs and are mostly discovered when looking in the mirror or during a physical examination. However, larger thyroid cysts may cause compression symptoms, such as pressing backward against the trachea or esophagus, leading to symptoms like breathlessness and discomfort swallowing. A small portion may also exhibit signs of thyroid dysfunction, such as hyperthyroidism or hypothyroidism, although this is relatively rare in clinical settings.


Which department to see for thyroid cysts?
For which department to consult for thyroid cysts, firstly if it is just a routine physical examination and a thyroid ultrasound reveals a thyroid cyst, it is recommended to first consult the endocrinology department. An assessment of thyroid function should be conducted to see if the thyroid is functioning normally or abnormally. If it is confirmed to be simply a thyroid cyst, then the size of the cyst should be considered in deciding the next steps for treatment. If the cyst is not large and thyroid function is normal, it might be advisable to observe it for some time. If the cyst causes symptoms due to compression, surgical treatment in the department of surgery might be necessary, or dealing with the thyroid cyst using techniques such as radiofrequency ablation could be considered. Therefore, it is advised to first visit the endocrinology department and, based on the opinion of the endocrinologist, if surgical intervention is needed, then consult the breast and thyroid surgery department.


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.


What foods are good for thyroid cysts?
For patients with thyroid cysts, it is necessary to check their thyroid function to understand their condition. For patients with hyperthyroidism, it is advised to avoid iodine-rich foods, such as seaweed, kelp, and seafood. However, patients with thyroid cysts are suggested to eat more foods that can enhance the immune system, such as shiitake mushrooms, mushrooms, wood ear mushrooms, walnuts, Chinese yam, and red dates. They can also eat some foods that help reduce nodules and swelling, such as spinach, mustard greens, and kiwifruit. Patients with thyroid cysts are advised to quit smoking and drinking, and avoid spicy and stimulating foods, such as chili peppers, Sichuan peppercorns, and onions. Additionally, they should avoid eating overly greasy foods.