Thyroid cyst

A thyroid cyst is a cavity formation in one of the most important glands of the human body - the thyroid gland - it is a benign, very small tumor containing colloidal contents inside.

Many endocrinologists combine nodular formations, cysts and adenomas into one category, there is still no clear boundary between these forms, although they differ in their structure. In clinical practice, cysts are formations of 15 millimeters and larger, everything smaller than this border is considered an enlarged follicle (from 1.5 mm and above). An adenoma is a benign mature tumor consisting of the epithelium of the thyroid gland, and a node is a formation in the form of a lesion, having a dense, fibrous capsule inside.

According to statistics, a cyst is diagnosed in 3-5% of all diseases of the glandula thyroidea - the thyroid gland. A thyroid cyst most often develops in women, in the initial stage it grows asymptomatically as a complication of the main endocrine disease, and very rarely becomes malignant (acquires a malignant form). It can be different in morphological form, but, as a rule, has a favorable prognosis with timely diagnosis and treatment.

International Classification of Diseases Code – ICD-10:

D34 - Benign neoplasm of thyroid gland

It is believed that 90% of diagnosed thyroid cysts do not pose a danger in terms of transformation into an oncological disease. The danger is posed by the underlying causes of the cysts, usually hyperplasia of the gland, thyroiditis, dystrophic changes in the follicles, infectious processes. In addition, whether a thyroid cyst is dangerous can be determined by an endocrinologist after a thorough examination, which can show the ability of neoplasms to cause suppuration, inflammation. Symptoms of possible complications of a cyst in a clinical sense are as follows:

• Hyperthermia is a high body temperature, sometimes up to 39-40 degrees.
• Enlarged cervical lymph node.
• General intoxication of the body.
• Localized painful symptom at the site of cyst formation.

Large cysts can form nodes, which in turn are dangerous in terms of malignancy (development into a malignant formation).

Causes of thyroid cysts

The causes of cyst formation are determined by the structure of the gland tissue itself – it consists of more than 30 million colloid-filled follicles (acini and vesicles). Colloid is a special protein gel-like liquid containing protohormones – special substances that function inside the cells that reproduce them. If the outflow of hormones and colloidal substance is disrupted, the follicles increase in size, small, often multiple cysts are formed. In addition, the causes of thyroid cysts are overexertion, overconsumption of energy-supplying hormones – T3 (triiodothyronine) and T4 (thyroxine). This is associated with psychoemotional stress, the rehabilitation period after a serious illness, after thermal exposure (severe cold or heat), which increase the production of hormones and the activity of the gland itself. The density of the thyroid tissue gradually loses its elasticity, transforming into altered areas in the form of a cavity filled with colloidal fluid and destroyed cells.

Also, the causes of thyroid cysts are explained by the following factors:

• Iodine deficiency.
• An inflammatory process in an unchanged gland is thyroiditis.
• Hormonal disorders, imbalance.
• An unfavorable environmental situation in the ecological sense.
• Intoxication, poisoning with poisons.
• Trauma to the gland.
• Congenital pathologies of the thyroid gland.
• Hereditary factor.

Symptoms of thyroid cyst

Thyroid cysts most often develop slowly and asymptomatically, which is explained by their small size and lack of pressure on the vascular system. As a rule, primary neoplasms are detected during routine examinations for other endocrine and hormonal diseases.

Symptoms begin to appear when the formation becomes quite large, sometimes up to 3 centimeters, often noticeable visually. However, as it grows, the tumor can provoke unnoticeable discomfort, which is worth paying attention to, since in the initial stage it is treated conservatively and does not require other methods of therapy. There are also cases when it forms and grows quite quickly, and can resolve on its own. Signs and symptoms of a developing benign formation in the gland can be as follows:

• A feeling of irritation in the throat.
• A feeling of slight compaction.
• Atypical timbre of voice, hoarseness.
• Pain as a sign of cyst suppuration.
• Subfebrile body temperature, possibly increasing to 39-40 degrees.
• Frequent feeling of chills.
• Headache that has no other objective causes.
• Visual change in the appearance of the neck, its contours.
• Enlarged lymph nodes.

Cyst less than 1 centimeter	Cyst from 1 to 3 centimeters	Cyst more than 3 centimeters
There are no subjective sensations	Self-determination by palpation is possible	The formation is palpable and visually noticeable.
There are no clinical manifestations.	Visible deformation of the neck Periodic discomfort is felt in the throat, in the neck area	Deformed neck Shortness of breath Dilated veins in the neck Dysphagia (difficulty swallowing food) Hoarseness Painful sensations on palpation Enlarged lymph nodes Rarely - elevated body temperature

Symptoms of a thyroid cyst may appear periodically, but even one episode of alarming signs should be a reason to see a doctor.

A colloid cyst is essentially a colloid node that forms as a result of non-toxic goiter. Nodular formations are enlarged follicles with flattened thyrocytes that line their walls. If the gland tissue structurally remains practically unchanged, then a nodular goiter develops; if the thyroid parenchyma changes, a diffuse-nodular goiter is formed. About 95% of diagnosed colloid neoplasms are considered to be quite benign, requiring only dispensary observation, but there is a remaining 5% that can be dangerous in terms of transformation into an oncological process. The main reason that provokes the development of colloid cysts is iodine deficiency in the body; heredity has a lesser effect on this endocrine pathology. In addition, excessive doses of radiation, as in the case of the atomic explosion in 1945 in the Japanese cities of Hiroshima and Nagasaki, or the accident at the Chernobyl Nuclear Power Plant, are also a provoking factor for many thyroid diseases.

At the initial stage, colloid nodes do not manifest clinical signs, formations up to 10 mm in size are not felt by a person and are not dangerous to health in principle. However, growing nodes can complicate the process of swallowing food, compress the esophagus, trachea, and recurrent nerve endings of the larynx. Another typical sign of a growing node is increased sweating, hot flashes, tachycardia, periodic outbursts of unreasonable irritability, which is explained by the excessive release of hormones into the bloodstream (thyrotoxicosis).

Almost all endocrinologists are unanimous in the fact that a colloid cyst of the thyroid gland does not require surgical treatment; its management only requires regular observation and monitoring of the condition of the gland using ultrasound examination.

A follicular cyst of the thyroid gland in clinical practice is defined as a follicular adenoma, which is much more correct and accurate, since such a formation consists of a large number of tissue cells - follicles, that is, a fairly dense structure that does not have a cavity like in a cyst. Follicular adenoma also rarely manifests itself clinically in the initial stage, and is visually noticeable only when enlarged, when it deforms the neck. This type of tumor is more dangerous in terms of malignancy and much more often degenerates into adenocarcinoma than a colloid cyst.

Follicular neoplasm is diagnosed in patients of any age – from children to adults, but most often in women.

Symptoms:

• A dense formation in the neck area that is easily palpated and sometimes even visually noticeable.
• No pain during palpation.
• Clear boundaries of the formation (on palpation).
• Difficulty breathing.
• Discomfort in the neck area.
• A feeling of a lump in the throat, constriction.
• Frequent coughing.
• Sore throat.
• If the cyst develops, there is a decrease in body weight.
• Irritability.
• Increased fatigue.
• Sensitivity to temperature changes.
• Sweating.
• Tachycardia.
• Increased blood pressure, pressure instability.
• Subfebrile body temperature is possible.

Diagnostics:

• Collection of anamnesis and subjective complaints.
• Palpation.
• Ultrasound examination of the gland.
• If necessary – puncture and histological analysis.
• Scintigraphic (radionuclide) examination using a radioindicator.
• Unlike colloid formations, follicular adenomas are difficult to treat conservatively and are most often operated on.

Cyst of the right lobe of the thyroid gland

As is known, the thyroid gland resembles a "butterfly" in structure, consisting of two lobes. The right side is slightly larger than the left, this is due to the fact that during intrauterine development, the right lobe of the thyroid gland is formed earlier, its follicles are formed more intensively, and the left one completes its formation 10-14 days later. Perhaps this explains the high prevalence of cysts of the right lobe of the thyroid gland. Just like typical neoplasms associated with the expansion of follicles, a right-sided cyst is usually benign and rarely increases to pathological sizes. If timely detection does not occur, and this is also a common phenomenon due to the asymptomatic process, the tumor can reach sizes of up to 4-6 centimeters. Such cysts already signal themselves with the following signs:

• Uncomfortable pressure in the neck area.
• A feeling of a constant lump in the throat.
• Difficulty swallowing, breathing.

Hyperthyroidism - feeling of heat, exophthalmos (excessively bulging eyes), hair loss, dyspepsia, tachycardia, aggression, irritability

A cyst of the right lobe of the thyroid gland is easily palpated when it increases by more than 3 millimeters as a solitary (single). To diagnose such a formation, as well as for multiple diffuse nodes, both ultrasound and biopsy of the cyst contents for histological (cytological) analysis are performed if it is 1 centimeter or more in size.

Right-sided cysts up to 6 mm are subject to conservative treatment and regular monitoring, the prognosis depends on the results of histology. Usually, even medications are not required, a certain diet with the inclusion of seafood and iodine-containing dishes in the menu is enough. It is also necessary to monitor the TSH indicators in dynamics, every six months. In 80-90% of cases, with timely detection of such formations, cysts are well treated with diet or drug therapy and are not operated.

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Cyst of the left lobe of the thyroid gland

The left lobe of the thyroid gland - lobus sinister can normally be slightly smaller in size compared to the right, this is due to the anatomical structure of the gland. Cysts can develop on both lobes, or be unilateral, for example, on the left side. A cyst of the left lobe of the thyroid gland less than 1 centimeter, as a rule, is subject to dynamic observation and does not require either conservative or, especially, surgical treatment. If it increases, a puncture is possible, during which the cavity is emptied and a special drug is administered - a sclerosant. This agent helps the cyst walls "stick together" and prevents relapse of the accumulation of colloidal contents in it. In addition, in case of an inflammatory, purulent process in the cyst, a puncture helps to identify the true causative agent of the infection and specify antibacterial therapy. In cases where a cyst of the left lobe of the thyroid gland is formed again after sclerotherapy, an operation is indicated - its resection.

Endocrinologists believe that in case of unilateral pathology of the gland, a compensatory mechanism is activated, that is, if the left lobe is overactive, then the right one will be either normal or hypoactive. Thus, a cyst of the left lobe is not a complex, life-threatening disease and is a solvable problem in terms of the functioning of the gland itself (TSH level) and a possible increase in size.

A left-sided cyst is diagnosed in a standard way:

• Palpation.
• Possibly a puncture.
• TSH (T3 and T4) analysis.
• Ultrasound of the thyroid gland.

Treatment usually includes iodine-containing drugs, a special diet, and monitoring the condition of the gland and the size of the tumor every six months. Various physiotherapeutic procedures, warming up, and radiation are unacceptable. With constant monitoring and compliance with all medical recommendations, a cyst of the left lobe of the thyroid gland has a very favorable prognosis.

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Thyroid isthmus cyst

Isthmus glandulae thyroideae - the isthmus is easily defined by palpation, unlike the thyroid gland itself, which should normally be neither visible nor palpable. The isthmus is a transverse, smooth, dense "roller" that performs the task of connecting the right and left lobes of the gland at the level of the tracheal cartilage. Any atypical thickening, enlargement or compaction of the isthmus should be a reason for examination by an endocrinologist to identify possible pathology, since this area is the most dangerous in terms of malignancy (oncological process).

Thyroid isthmus cyst is diagnosed as follows:

• Collection of anamnesis and subjective complaints.
• Palpation of the isthmus and the entire gland.
• Fine needle biopsy to differentiate the nature of the tumor (benign/malignant).

It should be noted that cyst puncture is recommended for all formations exceeding one centimeter in size, as well as for those patients who have a hereditary predisposition to endocrine diseases or those who live in an area of increased radiation activity.

If the isthmus cyst does not exceed 0.5-1 centimeters, it does not require special treatment. As a rule, regular ultrasound examinations are prescribed, dispensary registration is indicated. If the biopsy reveals the benign nature of the tumor, that is, it is diagnosed as colloid, the endocrinologist determines the treatment tactics, but today there are no drugs that could reduce or stop the growth of neoplasms. In cases where the thyroid isthmus cyst does not disrupt basic functions, does not affect the hormonal background and does not manifest painful symptoms, it is subject only to constant observation, monitoring.

Previously popular thyroxine is now recognized as insufficiently effective, in addition, its side effects often exceed its dubious effectiveness. Radioiodine therapy courses are not practiced in our country, they are mainly used in foreign clinics, therefore, if there is a suspicion of a malignant nature, its large size, an operation is possible.

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Small thyroid cysts

Small formations that are diagnosed as small cysts of the thyroid gland are usually not subject to either conservative or surgical treatment. In fact, these are pathologically enlarged follicles detected by the histological method. It should be noted that ultrasound examination is not able to determine the nature of small formations, especially if they do not exceed 1.5 millimeters in size. It is believed that all atypical neoplasms in the gland that exceed 1.5-2 millimeters are called cysts, that is, anechoic formations containing colloid. If ultrasound shows a hypoechoic formation, it is diagnosed as a node, but clarifying differentiation with such small sizes is possible only with the help of histology and Dopplerography.

Small thyroid cysts often disappear on their own when following an iodine-containing diet, eliminating exposure to heat and psycho-emotional stress. The prognosis for such colloid formations is almost 100% favorable.

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Multiple thyroid cysts

Endocrinologists consider the expression "multiple thyroid cysts" as a diagnosis to be incorrect. Rather, it is not a clinical definition of the disease, but a conclusion of instrumental studies, which include ultrasound. The term polycystic disease is basically excluded from the diagnostic dictionary and transferred to the category of definitions of tissue changes in any organ - ovaries, thyroid gland, kidneys. Multiple thyroid cysts are detected using ultrasound scanning as an initial pathological hyperplasia of the tissue structure in response to a deficiency of iodine salts. Most often, this is the first signal of developing thyroid pathology, for example, goiter. The main cause of this deformation is iodine deficiency, accordingly, treatment should be aimed at neutralizing the provoking factors - the impact of environmental, psychoemotional, food goitrogens and replenishing iodine. The so-called polycystic thyroid gland requires regular monitoring of its size, evaluation of its functioning, that is, the patient is simply under the supervision of a doctor and undergoes an ultrasound of the thyroid gland once every six months. In addition, it is advisable to develop a special diet, diet together with a nutritionist, possibly attending psychotherapy sessions to restore emotional balance.

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Thyroid cyst in children

Unfortunately, unfavorable environmental conditions, environmental pollution, unhealthy diet, solar activity and many other factors provoke the development of thyroid pathologies in both children and adults.

Diseases or changes in the structure of the child's gland most often develop during the intrauterine stage, especially if the pregnant woman already has a history of one or another form of endocrine disorder.

Thyroid cysts in children are quite rare, according to statistics, they are diagnosed in only 1% of all functional or pathological changes in the organ. However, it is childhood endocrine diseases that are considered the most dangerous in terms of malignancy, that is, possible degeneration into cancer.

Anatomically, the thyroid gland in children differs from the structure of the adult organ, its weight is less, and its size is somewhat larger. In addition, the lymphatic system and the thyroid gland of the child work more actively, since it is responsible for the production of growth hormones, protein synthesis, the work of the cardiovascular system and many other functions.

Reasons why a thyroid cyst may develop in children:

• CHAT – chronic autoimmune thyroiditis.
• Acute - diffuse, purulent or non-purulent thyroiditis.
• Traumatic injury to the gland as a result of a fall or blow.
• Iodine deficiency.
• Malnutrition.
• Poor environmental conditions.
• Hereditary factor.
• Puberty with hormonal disorders.
• The clinical presentation of the tumor in adults is almost identical.

Symptoms that may indicate a benign tumor include:

• The initial stage is asymptomatic.
• A painful sensation in the throat is possible if the cyst is large.
• Sore throat.
• Dry, frequent cough without objective reasons.
• Difficulty swallowing food (dysphagia).
• Rapid breathing, often shortness of breath.
• A visual change in the shape of the neck is possible.
• Capriciousness, irritability.

In addition, thyroid cysts in children can develop very quickly and put pressure on the vocal cords to such an extent that the child loses his voice.

The greatest danger is posed by a purulent cyst, which provokes hyperthermia and general intoxication of the body. Also, sad statistics say that more than 25% of all neoplasms detected in children are malignant. Therefore, parents need to be very attentive to the slightest manifestations of signs of thyroid disease, especially if the family lives in an area with an increased radioactive background.

The diagnostics are similar to the examination plan for an adult:

• Collection of anamnestic information, including hereditary.
• Examination and palpation of the gland.
• Ultrasound of the thyroid gland.
• Tumor puncture.
• If a malignant form is suspected, a biopsy is performed.

Treatment for a thyroid cyst in a child depends on the diagnostic results; it can be either conservative or surgical. The prognosis for timely detection of small benign formations is usually favorable.

Thyroid cyst in adolescents

The current problem - thyroid diseases, concerns both adults and children, especially teenagers, whose age involves rapid growth, active work of the hormonal system. In addition, thyroid pathologies - the thyroid gland are becoming more common due to iodine deficiency, unfavorable environmental conditions, which also affects the decrease in function, activity of the gland. Reduced production of thyroid hormones disrupts the normal development of the body during puberty, changes metabolic processes, slows down the growth and development of the central nervous system. Against the background of all the factors provoking endocrine pathologies, a thyroid cyst in adolescents is not uncommon today. Most often, such neoplasms are detected randomly or during routine medical examinations. About 80% of all pathologies are colloid cysts, nodes. Despite the fact that this form of formation is considered to be quite favorable in terms of prognosis, benign, thyroid cancer in children and adolescents has become 25% more common than 15 years ago.

With timely detection of cysts, nodes, and thyroid adenomas, adequate complex treatment or surgery, the mortality rate is very low - no more than 5%.

The diagnostics that a thyroid cyst in adolescents involves are similar to the standards for examining the gland in adults:

• Examination, palpation of the lymph nodes and thyroid gland.
• Ultrasound of the gland.
• FNAB – fine needle aspiration biopsy.
• Blood test for TSH.
• Radioisotope examination is possible.

The choice of method and treatment of a cyst depends on its nature, size, location – left, right lobe, isthmus.

General recommendations for adolescents living in areas with low levels of iodine salts are also standard and are related to the prevention of hypothyroidism, as the most frequently detected disease. The iodine intake rate for children over 12 years old is 100 mcg per day.

Thyroid Cyst and Pregnancy

Waiting for a baby is an extremely joyful and at the same time difficult period for every pregnant woman. Especially if, when registering at the clinic, certain disorders in the thyroid gland are detected. You should not attribute the detected problems to hormonal changes due to pregnancy, it is better to play it safe and undergo a full examination so as not to harm either yourself or the fetus, which so needs a healthy mother's body. Any disorder in the thyroid gland, including a thyroid cyst, and pregnancy do not go well together. First of all, in terms of the normal intrauterine development of the baby, as well as in relation to the course of pregnancy and possible complications during childbirth. Of course, excessive anxiety, especially panic, will not be useful for the expectant mother, so it would be advisable to learn as much as possible about what a thyroid cyst is.

Etiology, factors that can provoke the development of cysts, nodes, adenomas of the thyroid gland:

• The fact of pregnancy itself is a physiological change in the body as a whole, in the hormonal system and in the structure of the gland in particular.
• Deficiency of iodine salts.
• Inflammatory processes in the gland, thyroiditis.
• Labile, unstable psyche, stress.
• Heredity.
• Rarely – thyroid gland injuries.

A thyroid cyst and pregnancy can “coexist” quite peacefully if the formation is small in size (up to 1 centimeter) and benign in nature; as a rule, these are colloid cysts, which tend to resolve on their own.

The clinical picture can be quite varied, unlike the symptoms of neoplasms in women who are not expecting a child. Expectant mothers are more sensitive, so they may notice some discomfort in the neck area at the earliest stages. Also, among the signs of a developing cyst, there may be an atypical timbre of the voice - hoarseness, irritation, difficulty swallowing even small pieces of food. All these manifestations do not necessarily indicate that the cyst is large, rather, it is an indicator of heightened sensations of a pregnant woman.

More dangerous are purulent cysts and abscesses, which can develop against the background of reduced immunity and concomitant inflammatory diseases.

Thyroid cysts in pregnant women are diagnosed in a standard way, but the percentage of early detection is much higher, this is due to mandatory dispensary examinations and observation. Often, expectant mothers are completely in vain afraid of punctures, this is not only a way to accurately determine and confirm the benign nature of neoplasms, but also to sclerose the cyst in time so that it cannot increase further. Also positive information is the fact that a thyroid cyst and pregnancy are quite compatible and the diagnosed formation cannot be the basis for termination of pregnancy. Cysts are subject to observation, and the woman is also prescribed iodine-containing drugs and rest adequate to the condition. Large formations that can significantly disrupt the functioning of the thyroid gland are operated only after childbirth and in case of urgent need.

Consequences of thyroid cysts

The prognosis and consequences of a thyroid cyst are directly related to diagnostic indicators and results. If the tumor is determined to be benign, the prognosis is favorable in almost 100% of cases, however, it should be taken into account that the neoplasm may recur and require repeated examination and treatment.

In addition, the consequences of a thyroid cyst can be quite unfavorable if the formation is diagnosed as malignant, in this sense, the presence or absence of metastases, their number and localization play a major role. If metastasis has not occurred, a thyroid cyst has a high percentage of curability and a favorable treatment outcome. It should be clarified that a true cyst of the gland is extremely rare in clinical practice, most often as a secondary formation against the background of an already developing oncopathology. The most unfavorable consequences are with total removal - strumectomy, which is indicated for extensive metastases. In such cases, the entire thyroid gland is completely removed, with the capture of surrounding fatty tissue and lymph nodes to stop the process and neutralize further tumor development. In fact, the consequences of a malignant thyroid cyst are complications that are typical of an extensive operation. With strumectomy, as a rule, it is impossible to avoid damage to the vocal cords, so patients often either partially or completely lose the ability to speak. In addition, after such interventions, the postoperative rehabilitation period involves taking certain medications, including thyroid hormones.

Fortunately, malignant cysts are diagnosed extremely rarely, and benign ones are treated with iodine-containing products and constant monitoring by an endocrinologist.

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Diagnosis of thyroid cysts

Diagnostic measures to detect thyroid pathologies should ideally be preventive, i.e. dispensary and regular. However, most often cysts are accidental findings and during examinations for other diseases.

Diagnosis of thyroid cysts is carried out using the following methods and techniques:

• Collection of anamnesis.
• Visual examination of the patient.
• Palpation of the gland and lymph nodes.
• Ultrasound examination of the gland for primary differentiation of cysts, adenomas, nodes.
• Puncture (fine needle aspiration) to clarify the nature of the neoplasm, the type of tumor - simple, with yellowish-brown contents, a congenital cyst with transparent contents, or a purulent cyst.
• Simultaneous sclerotherapy (during puncture) is possible.
• Blood test for TSH, T3 and T4.

Scanning of the body, lobes, and isthmus of the gland is radioactive scintigraphy, which determines:

1. A cold node as an indicator of possible oncology (iodine does not penetrate into the gland tissue).
2. Warm node – distribution of the injected iodine into the tissue and cyst evenly.
3. Hot node – active absorption of iodine salts as an indicator of a cyst or node.

• Computed tomography of the gland.
• Pneumography for suspected metastasis.
• Angiography.
• Laryngoscopy may be performed to assess laryngeal involvement.
• Bronchoscopy to evaluate tracheal lesions.

Thyroid ultrasound for cysts is the second stage of diagnostics after the initial examination and palpation. Ultrasound scanning is considered one of the most effective non-invasive methods for assessing the condition of the thyroid gland, which helps to identify small nodes, cysts, adenomas or tumors with almost 100% accuracy.

Indications for ultrasound:

• The shape of the neck is atypical and deformed.
• Enlarged lymph nodes.
• Blood test results for TSH.
• Registration for pregnancy.
• Preparing for surgery.
• Menstrual cycle disorders, hormonal imbalance.
• Monitoring the thyroid gland.
• Persistent infertility.
• Dysphagia.
• Excessive anxiety.
• Taking hormonal drugs.
• Hereditary endocrine diseases.
• Occupational hazards associated with working in high radiation areas.
• Age-related changes – menopause.
• Preventive examination.

It is important to note that almost all of the listed reasons for examination may also be provoking factors for the development of a thyroid cyst.

What are the possibilities and what indicators does an ultrasound of the thyroid gland determine in case of a cyst?

• Contours of the gland.
• Sizes of the gland lobes.
• Tissue echogenicity (thyroid).
• Location of the thyroid gland.
• Puncturing control.
• Evaluation of the structure of neoplasms.
• Determination of the shape and number of cysts.
• Assessment of the state of lymphatic drainage.
• Identification of possible metastases.

How does the examination process work?

Scanning of the gland and detection of cysts and other formations is performed in a lying position, the neck is lubricated with a special gel that creates sliding and ensures ultrasound conductivity. The procedure is absolutely painless and safe, its duration is short, depends on the condition of the gland and the practical experience of the specialist conducting the examination. The patient does not need to prepare, but it is better to perform an ultrasound on an empty stomach to avoid vomiting during possible light pressure on the gland with the sensor.

A cyst no larger than 1 centimeter, a 4 mm thyroid cyst is a small formation that can be detected both by ultrasound and by scintigraphy. It is almost impossible to palpate such a cyst, it is so small. Small cysts can be either single or multiple, they do not give clinical symptoms and are not felt as discomfort. The only exception, which, however, is extremely rare, is a purulent cyst, which can hurt with accidental pressure on the neck. A 4 mm thyroid cyst cannot be treated, it is detected during a routine examination and then monitored for possible enlargement. With timely detection and replenishment of iodine salts, such a neoplasm does not grow in size, moreover, small colloid cysts tend to resolve on their own. Some endocrinologists do not consider 4 mm cysts as a formation in principle, considering it a functionally altered follicle. However, if a small cyst is diagnosed, it should be monitored with regular ultrasound.

The main method for determining the nature of a cyst is puncture. Puncture of the thyroid gland allows you to clarify the type of cyst, assess the degree of its benignity or verify the potential danger. In addition, puncture is a therapeutic method, which consists of aspiration of the contents of the cyst. The procedure is carried out using a very thin needle, which is inserted into the wall of the larynx, previously lubricated with anesthetic. The process is absolutely painless, moreover, after it the patient, as a rule, feels noticeable relief, since the cyst is emptied and stops squeezing the surrounding tissues and vessels. It should be noted that there are cases of cyst recurrence after aspiration, then another puncture is indicated.

Thyroid puncture is prescribed for almost all types of cysts larger than 3 millimeters to avoid the risk of cyst malignancy, which is rare, because a true cyst, that is, one capable of transforming into a tumor, is considered a clinical "myth". There is no recovery period after puncture, the procedure is performed on an outpatient basis.

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Treatment of thyroid cysts

Treatment of thyroid cysts depends on the pathology detected and can be conservative, surgical or involve regular monitoring without the use of any drugs. As a rule, thyroid cysts are subject to dynamic monitoring in order not to miss the moment of their enlargement. The main effective method of treatment is puncture with aspiration and sclerotherapy of the cyst walls. Doctors use alcohol as sclerosants. During aspiration, the contents are not only removed, but also sent for histological examination. If the cyst grows again after the puncture, recurs several times, surgery is indicated.

Small cysts that do not interfere with the thyroid gland can be treated with hormonal thyroid medications. However, many doctors today try to avoid such prescriptions and try to control the cyst with an iodine-containing diet and iodine preparations. Almost all cysts are benign and have a favorable prognosis, but require periodic ultrasound scanning.

Operations are necessary to remove large cysts and can be performed in the following forms:

• Resection of most of the thyroid gland in case of bilateral large cysts.
• Hemistrumectomy is the removal of one lobe of the gland.
• Total removal of the gland, surrounding tissues and lymph nodes in case of malignant tumors.
• Thyroid cyst surgery.

Surgical intervention is indicated in the following cases:

• A large cyst that presses on the neck and larynx, causing suffocation.
• Cyst:
  • which causes dysphagia.
  • which deforms the neck - a cosmetic defect.
  • which disrupts hormonal balance.
  • which is festering.
  • which is diagnosed as malignant.

Surgery for thyroid cysts is indicated for solitary tumors that are diagnosed as nodular; as a rule, hemithyroidectomy is performed.

Cysts smaller than 10 millimeters are subject to resection. The gland is completely removed in extreme cases, in case of malignancy of the neoplasm, metastasis, which is extremely rare in cystic forms.

Currently, endocrinologists try to treat cysts using minimally invasive methods, such as sclerotherapy, since major surgical intervention is always accompanied by additional risks and complications.

Thyroid cyst removal

Only an endocrinologist can determine whether a thyroid cyst needs to be removed. Today, progressive doctors have begun to abandon the previously popular total operations for cysts, adenomas, or thyroid nodes.

Just 10 years ago, almost 70% of surgeries were performed without real, life-threatening justifications. Like any surgical intervention, removal of a cyst or thyroid nodule is a test for the patient, and is also accompanied by possible complications and consequences.

Currently, thyroid cyst removal is possible only for strict indications that do not suggest choosing another method. The following methods are used to remove cysts:

• FNAB – fine needle aspiration biopsy.
• Puncture.
• Sclerotherapy.
• Laser coagulation.
• Complete surgical operation.

What tests should be taken before removing a cyst?

• OAC – complete blood count.
• Blood for the presence or absence of hepatitis, HIV, sexually transmitted diseases.
• Blood for TSH.
• Ultrasound of the gland.
• Puncture.
• Biopsy.

Thyroid surgery can be partial or complete, if the cyst is associated with an autoimmune process, it is impossible to do without removing the gland completely. There are modern technologies that allow leaving part of the structures - the laryngeal nerve, parathyroid glands. Removal of a large cyst is performed under general anesthesia, lasts no more than 1 hour, and the recovery process does not exceed 3 weeks. Colloid cysts are not operated on, they are subject to dynamic observation.

Sclerotherapy of thyroid cysts

This is one of the ways to remove a small cyst in a timely manner. Sclerotization is performed by introducing a substance into the cyst cavity - a sclerosant, which is capable of "gluing" the walls of the cavity of the formation. As a rule, alcohol is used for these purposes. Alcohol "welds" the blood vessels, causing a kind of burn, the walls of the cyst fall, stick together and scar. The entire procedure is carried out under ultrasound monitoring, a needle is inserted into the cavity of the neoplasm in order to aspirate the contents of the cyst.

Sclerotherapy of thyroid cysts is the suction of almost all colloid from the cavity, in place of which a sclerosant is injected in a volume of 30 to 55% of the removed fluid. Alcohol is in the hollow cyst for no more than 2 minutes, then removed with a needle. The procedure is virtually painless, but may cause a burning sensation.

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Treatment of thyroid cysts with folk remedies

Folk recipes for treating thyroid cysts are a thing of the past, as endocrinologists believe, but there are forms and types of formations that respond well to treatment in this way.

Treatment with folk remedies involves the use of the following recipes:

• Tincture of zamaniha - 20 drops per 100 milliliters of boiled cooled water twice a day for a month. Zamaniha has an immunomodulatory effect, activates tone, energy.
• Some herbalists recommend using oak bark, which is applied as a compress to the identified cyst.
• Green walnut leaves are infused in alcohol - a glass of young leaves per 500 milliliters of alcohol. Leave for 2 weeks, take 5 drops with water three times a day for a month.
• Infusion of walnut leaves. Pour 100 leaves with half a liter of boiling water, leave for 30 minutes, drink the strained decoction during the day for a month. Walnut is a storehouse of iodine, which the thyroid gland lacks so much.
• It is good to make compresses on the neck from iodized salt (wrap in a cloth).
• Grate raw beets, which also contain iodine, wrap in a cloth and apply to the neck.
• A honey compress can help treat a thyroid cyst. Honey is mixed with rye bread, the resulting mass is applied topically to the cyst site and left overnight.
• It is necessary to take flaxseed oil - a teaspoon twice a day before meals for a month.
• There is an opinion that if you wear amber beads, then the cyst and thyroid nodes will not increase in size and may even dissolve.

Nutrition for thyroid cysts

Since most causes of thyroid cyst formation are associated with iodine deficiency, an important step in treatment is a special diet.

Nutrition for thyroid cysts involves eating foods and products that contain iodine salts:

• All types of seafood – sea fish, shrimp, crabs, seaweed, squid, cod liver.
• Persimmon.
• Dates.
• Black chokeberry.
• Prunes.
• Feijoa.
• Black currant.
• Cherry.
• Beetroot (raw, boiled, baked).
• Eggplants.
• Radish.
• Tomatoes.
• Spinach.
• Walnuts.
• Garlic.
• Buckwheat.
• Herring.
• Leaf salad.
• Millet.

It is necessary to limit the consumption of such products (goitrogens) if you have been diagnosed with goiter:

• Peach.
• Cabbage (all types).
• Jerusalem artichoke.
• Radish.
• Radish.
• Spinach.

You should not get carried away with sweet dishes, smoked foods, fried meat, lard, canned food. Food should be salted with iodized or sea salt. Regular intake of dietary supplements is possible, which should be discussed with your doctor.

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Prevention of thyroid cysts

Preventive measures to avoid thyroid pathologies are a global task that should be addressed at the state level. However, at home, you can also follow certain rules and recommendations that will reduce the risk of developing tumors in such an important organ.

• Regular intake of the required daily dose of iodine salts.
• Use of iodized salt.
• Minimize sun exposure, especially in summer.
• Be careful with physiotherapy procedures; they should be prescribed by a doctor.
• The neck should be protected from injury, hypothermia, and overheating.
• It is necessary to regularly take vitamins that cannot accumulate.
• Every six months you should undergo an examination - inspection, palpation, ultrasound.
• It is necessary to learn to cope with mental stress and avoid stress.
• In cases where psycho-emotional stress is inevitable, plan relaxation exercises and attend psychotherapy sessions.
• Avoid prolonged exposure to direct sunlight.

Of course, the prevention of thyroid cysts depends on many factors, including socio-economic ones, but the prognosis and outcome of treatment of the identified disease depend on preventive measures.