Can thyroid cysts grow larger?

Written by Luo Juan
Endocrinology
Updated on May 26, 2025
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Some thyroid cysts can grow larger. A thyroid cyst refers to a fluid-filled sac found in the thyroid gland, typically round in shape with a diameter ranging from two to five centimeters. Generally, these cysts are painless or only mildly painful. Most are solitary nodules, though a few are found in multiple nodules. Thyroid cysts are not an independent disease; they can result from simple goiter, nodular goiter, or degenerative changes in thyroid adenomas. Some cysts may also form due to thyroid cancer, through processes like hemorrhaging and necrosis. At least 4% of the population can feel thyroid nodules larger than one centimeter, and about 5% to 20% of these nodules are cystic. Particularly when individual nodules exceed four centimeters in diameter, thyroid cysts have a 4% to 5% rate of malignancy. Therefore, it is possible for thyroid cysts to grow larger.

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Written by Chen Xie
Endocrinology
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How should thyroid cysts be treated?

Thyroid cysts refer to fluid-containing sac-like formations found in the thyroid gland. For their treatment, thyroid cysts are a type of benign tumor of the thyroid. In imaging studies, if the nodule's diameter is less than one centimeter, it usually presents no clinical symptoms or signs. Regular follow-ups with thyroid ultrasonography and thyroid function tests are advised. If there is no trend of enlargement, continued observation without surgical intervention can be appropriate. However, if the nodule's diameter is greater than one centimeter, or if it is located on the surface of the thyroid, the local skin may show a protrusion or bulge, and the cyst may continue to grow, pressing on the trachea or even the esophagus, causing symptoms such as chest tightness, difficulty breathing, a feeling of swallowing, and obstruction. It is important to seek medical attention in a timely manner, undergo a fine needle aspiration biopsy if necessary, and surgical treatment may be required if needed.

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Written by Chen Xie
Endocrinology
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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.

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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 Luo Juan
Endocrinology
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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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Written by Zhao Xin Lan
Endocrinology
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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.