How to treat thyroid cysts

Written by Zhao Xin Lan
Endocrinology
Updated on May 26, 2025
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The treatment of a thyroid cyst depends on its size and location. Generally, a thyroid cyst is a benign lesion that presents as a space-occupying lump at the Adam's apple. If the cyst is relatively large, it might cause local compression symptoms such as pain, difficulty swallowing, and a hoarse voice. If the tumor cyst is small, it might not show any obvious symptoms, in which case it can be monitored over time. If the cyst is larger than four centimeters and causes discomfort such as local compression symptoms, corresponding surgical treatment is needed, or minimally invasive procedures such as cyst fluid aspiration or microwave ablation of the cyst.

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Written by Luo Juan
Endocrinology
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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.

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Written by Zhang Li
Endocrinology
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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.

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Written by Zhao Xin Lan
Endocrinology
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Is a thyroid cyst serious if it becomes malignant?

Thyroid cysts are generally benign lesions, so their malignancy rate is not high, and they generally do not become malignant. Thyroid cysts can be solitary or multiple, and usually grow slowly without any clinical symptoms. Routine monitoring is mainly based on color Doppler ultrasound to observe changes in the cysts. If the cyst shows calcification of the cyst wall or rapid growth, attention should be given to whether there are other changes or internal bleeding within the cyst. Timely surgical treatment can lead to a very good prognosis.

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Written by Zhao Xin Lan
Endocrinology
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Can you get pregnant with a thyroid cyst?

Thyroid cysts refer to sac-like formations within the thyroid gland that contain fluid, typically benign with rare cases of malignancy. The fluid inside these cysts, also known as blisters, has no secretory function and does not affect thyroid function, making it possible to become pregnant with a thyroid cyst. However, it is important to note that during pregnancy, if the cyst rapidly enlarges or if there is localized pain, it could be due to bleeding inside the cyst which requires urgent treatment. Aspiration of the cyst fluid can be done through fine needle aspiration to relieve pressure, and ethanol ablation can be used to close the cyst cavity. This minor surgery is generally tolerable and does not affect pregnancy.

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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.