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 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 Zhang Li
Endocrinology
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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.

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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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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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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.