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Thyroid cyst: Do you need to be concerned?


Thyroid cyst: Do you need to be concerned?


Thyroid cyst: Do you need to be concerned?

A cyst, by definition, contains fluid. Thyroid cysts are regions of the thyroid that are enlarged and filled with fluid. They may be small (1 cm) or sometimes very large and can develop slowly or arise suddenly. Thyroid nodules can also degenerate and become fluid-filled sacs entirely or have a combination of solid and cystic areas. Thyroid cysts can become large due to sudden bleeding within them. If they rapidly enlarge, they can cause symptoms like difficulty in swallowing, pain, and rarely change in voice due to compression on the vocal cords.
Usually, thyroid cysts are discovered when a routine ultrasound is done or when a thyroid biopsy (removal of a sample of tissue from the body for examination) is performed. If the cysts are filled with only fluid, they are usually not cancerous. In case, they do contain solid components, the chances are that it could be cancerous. In about 15% of cases, these cysts may spontaneously resolve.
What are the different types of thyroid nodules?
Thyroid nodules may be entirely cystic, in which case there are no solid components detectable within the fluid. Alternatively, the nodule may be complex, and contain both fluid and solid components. Cystic nodules may expand and enlarge suddenly sometimes due to hemorrhage or bleeding within a smaller pre-existing nodule. In some cases, rapidly enlarging cysts may produce symptoms in the neck, including pain, trouble swallowing, and rarely, compression of vocal cords leading to a change in voice quality.
Do I have to be concerned?
Most of the thyroid cysts are usually harmless and persist for many years without creating any complications. Over a period of time, these cysts may shrink in size. Sometimes, they can become larger and unsightly and cause discomfort. If they do not enlarge in size and cause any problem, they can be left alone. However, complications like bleeding into the cyst can occur and the cyst can suddenly enlarge in size. This can cause pain, anxiety, difficulty in breathing, and increase in the rate at which your heart beats. If this happens, thyroid cyst will have to be treated immediately.
Do I need testing?
If your doctor suspects that you have a thyroid cyst, he will perform a thorough physical examination of the neck and surrounding areas. He will order a blood test to check the thyroid hormone levels. This test helps to assess how well your thyroid gland is functioning. Usually, the thyroid function test results are normal even if you have thyroid cyst.
Your doctor will recommend a thyroid ultrasound (scan, which uses sound waves to produce picture of the thyroid gland) to distinguish the fluid-filled cyst from a solid nodule. This will help your doctor understand the size, shape, and consistency of the cyst, and also decide on the treatment of the condition. You may have to undergo another test called the radioactive iodine scan. During this test, you will be given a radioactive substance. This test will help your doctor to look at the cyst and the rest of the thyroid tissue.
Your thyroid gland takes up radioactive iodine and thereby become visible on the scan. An ultrasound-guided biopsy will also be carried out using a fine needle. A sample of thyroid tissue and the fluid will be taken and examined under the microscope to rule out the possibility of cancer. Usually, the fluid is clear yellow or reddish in color, and it has high thyroid hormone levels. Sometimes even pus may be present, which indicates that the cyst is actually an abscess (cavity containing pus and surrounded by inflamed tissue). Rarely, thyroid cysts can be due to papillary thyroid carcinoma.
How will my doctor treat thyroid cyst?
Surgery is not usually required, if you have a thyroid cyst. These cysts have a tendency to recur. Hence, your doctor will drain the thyroid cyst under ultrasound guidance and inject either tetracycline or ethanol into the cyst. This type of treatment usually prevents recurrence of the cyst. You do not need to be hospitalized, and this type of procedure is carried out even without anesthesia. Your doctor may recommend surgery, if the cyst keeps recurring, and if he suspects it to be cancerous.
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