06/29/2011 - Questions and Answers

Recurring Thyroid Cysts

By: Novoviva webmaster

Tools:
Recurring Thyroid Cysts

Question

I've had one thyroid cyst removed, which was benign. Now I've got another, and my doctor says it should come out. Is this going to continue for the rest of my life? Would it be better to have my whole thyroid removed?

Answer

Your concerns are understandable as there are no guarantees that other cysts will not grow, but there are other options available as well as surgical removal of thyroid cysts. However, total thyroid removal ( thyroidectomy) is still not considered a viable option for management of benign thyroid cysts.
 

The thyroid gland is important in controlling many different basic functions of the body. The gland makes thyroid hormone, which is essential in controlling these functions. Cysts are like water balloons, they are small pockets of fluid which can develop in the thyroid gland and these are not terribly important. The thyroid cysts do not interfere with the hormone production and really have no significance. They do however tend to recur. The best test to look at these is an ultrasound exam of the thyroid - this is also useful in looking for thyroid masses, which could be more significant, or the presence of a goiter. A goiter is a large growth of the thyroid due to lack of correct function - goiters are usually seen in people with hypothyroidism (under active thyroid). At this point, a biopsy is not needed unless the ultrasound shows a specific thyroid mass, not just the cysts. The best place to start is with the thyroid function tests and the ultrasound. A thyroid nodule that appears to be filled with fluid on ultrasound is referred to as a cystic nodule. Cystic nodules that are entirely filled with fluid with no solid tissue evident are considered to be simple cysts. These simple cysts are almost always benign (non cancerous). They can be drained with a fine needle, though they have a tendency to recur. Cystic nodules that contain clusters of solid tissue amidst collections of fluid are considered to be complex cysts. While the majority of these complex cysts are benign, a small percentage of them may harbor cancer. Fine needle aspiration biopsy of the solid portions of a complex cyst can help determine whether it is suspicious for cancer.
 

Perhaps you could discuss this information provided, with your treating doctor. Resolution of recurrent thyroid cysts with tetracycline instillation has be found to be successful in most people. Nine patients with recurrent purely cystic thyroid nodules after one or two previous cyst aspirations, were treated with repeat cyst aspiration and instillation of intracystic tetracycline hydrochloride. All but two of the patients' cysts resolved completely and have not recurred after a follow-up period of 12 to 50 months. Another option is ethanol instillation. Instillation of ethanol into recurrent cystic lesions of the thyroid has proved to be a "simple, safe, economical, and effective treatment". Please see links provided below.
 

Related Links

Thyroid cysts
Tetracycline instillation for recurrent cysts
Ethanol Instillation

 

Created on: 10/16/2006
Reviewed on: 06/29/2011

Your rating: None Average: 5 (1 vote)
Tools:
Anonymous wrote 2 years 6 days ago

i had a cyst removed but now . it came back. The doctor did a biopsy but he said that the results were inconclusive. Is there sumthing wrong?

June Chen, MD wrote 2 years 35 weeks ago

Surgical care for goiters is generally reserved for large goiters that are compressing on nearby structures and causing symptoms, malignant goiters, and goiters that do not respond, or are not amenable, to other forms of therapy, such as hormone suppression. Without knowing all of your medical history or additional details about the tumour on your thyroid, it is not possible to make recommendations on future treatment. While close observation may be a reasonable option for managing your condition, it is recommended that you discuss your questions and concerns with your physician.

Anonymous wrote 2 years 36 weeks ago

In 1999 I had a 5.2cm follicular Adenoma which resulted in a R hemithyroidectomy in one of our main hospitals in Brisbane. Now I have a 6.4cm tumour on my L goiterous thyroid. My now DR. would like me to have 6 monthly checkups to keep up with the tumour's progress. My feeling is that I want it out! Can I request a needle aspiration now??? What do you suggest??