By: Novoviva webmaster
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?
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.
Tetracycline instillation for recurrent cysts