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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Can thyroid cysts become cancerous?

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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Do thyroid cysts hurt?

Thyroid cysts sometimes hurt and sometimes do not. A thyroid cyst refers to a round, fluid-containing cystic structure found in the thyroid, generally 2-5 centimeters in diameter, smooth, usually painless or with mild pain, and can move up and down with swallowing. If the cyst is large or there is bleeding inside the cyst, it may cause some compressive symptoms such as pain, difficulty swallowing, breathing difficulties, and hoarseness. Therefore, whether a thyroid cyst is painful generally depends on the size of the cyst and whether there is bleeding inside it.

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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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Can people with thyroid cysts eat sea fish?

The exact cause of thyroid cysts is not very clear, but some scholars believe it is related to iodine metabolism. Therefore, in areas where iodine is particularly lacking or particularly abundant, the incidence of thyroid cysts tends to increase. Hence, the diet should avoid both too low and too high iodine intake. As for eating sea fish, occasional consumption should be acceptable. However, eating sea fish daily may lead to excessive iodine intake, potentially causing further development of the cysts.

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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.