Thyroid cyst

A thyroid cyst - abdominal mass in one of the most important glands of the human body, the thyroid, is a benign, very small tumor that has colloidal contents inside.

Many endocrinologists unite the nodules, cysts and adenomas in one category, there is still no clear boundary between these forms, although they are different in their structure. In clinical practice, cysts are called formations of 15 millimeters, all that is less than this limit is considered an enlarged follicle (1.5 mm and above). Adenoma is a benign mature tumor consisting of the epithelium of the thyroid gland, and a node is a lesion that has a dense, fibrous capsule within it.

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

The code for the international classification of diseases - ICD-10:

D34 - Benign thyroid neoplasm

It is estimated that 90% of diagnosed thyroid cysts do not pose a danger in terms of transformation into cancer. Danger are the primary causes of the appearance of cysts, as a rule, it is gland hyperplasia, thyroiditis, dystrophic changes in the follicles, infectious processes. In addition, if a cyst of the thyroid gland is dangerous, an endocrinologist can determine after a thorough examination, which can show the ability of tumors to cause suppuration and inflammation. Symptoms of possible complications of a cyst in a clinical sense are manifested as follows: 

• Hyperthermia - 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.

Cysts of large sizes can form nodes, which in turn are dangerous in the sense of malignancy (escalating into a malignant tumor).

Causes of thyroid cyst

The causes of cyst formation are due to the very structure of the gland tissue - it consists of more than 30 million follicles filled with colloid (acini and vesicles). A colloid is a special protein gel liquid containing protohormones - special substances that function inside those cells that reproduce them. If the outflow of hormones and colloidal substance is disturbed, the follicles increase, small, often multiple cysts form. In addition, the causes of thyroid cyst lie in overvoltage, overuse of energy-supplying hormones - T3 (triiodothyronine) and T4 (thyroxin). This is associated with psycho-emotional stress, rehabilitation period after a serious illness, after thermal effects (extreme 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 modified areas in the form of a cavity, filled with colloidal liquid and destroyed cells.

Also the causes of the cyst of the thyroid gland are explained by such factors: 

• Iodine deficiency.
• Inflammatory process in the unchanged gland - thyroiditis.
• Hormonal imbalance.
• Unfavorable environment in an ecological sense.
• Intoxication, poisoning with poisons.
• Trauma of the gland.
• Congenital pathologies of the thyroid gland.
• Hereditary factor.

Symptoms of thyroid cyst

The thyroid cyst often develops slowly and asymptomatically, due to its small size and lack of pressure on the vascular system. As a rule, primary neoplasms are detected at scheduled inspections for other diseases of the endocrine, hormonal nature.

Symptoms begin to appear when the formation becomes quite large, sometimes up to 3 centimeters, often visually noticeable. However, as the tumor grows, it can provoke inconspicuous discomfort, which is worth paying attention to, since at the initial stage it is treated conservatively and does not need other methods of therapy. Also, there are cases when it is formed and grows pretty quickly, and may self-dissolve. Signs and symptoms of a developing benign tumor in the gland may be: 

• Sore throat.
• Feeling small compaction.
• Atypical timbre of voice, hoarseness.
• Pain as a sign of suppuration of the cyst.
• Low-grade body temperature, the temperature may rise to 39-40 degrees.
• Frequent sensation of chills.
• Headache with no other objective reasons.
• Visual change 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 feelings	Perhaps an independent definition of palpation	Education is palpable, visually noticeable
Clinical manifestations no	Visible deformity of the neck Feels periodical discomfort in the throat, in the neck	Deformed neck Dyspnea Dilation of neck veins Dysphagia (difficulty swallowing food) Hoarseness Painful sensations on palpation Swollen lymph nodes Rarely increased body temperature

Symptoms of a cyst of a thyroid gland can appear periodically, but even one episode of disturbing signs should be a reason for going to a doctor.

A colloid cyst is, in fact, a colloid knot, which is formed as a result of non-toxic goiter. Nodular formations are dilated follicles with flattened thyrocytes that line their walls. If the gland tissue does not practically change structurally, then a nodular goiter develops, if the thyroid parenchyma changes, a diffuse nodular goiter forms. About 95% of diagnosed colloidal neoplasms are considered to be quite benign, requiring only follow-up, but there are the remaining 5% that can be dangerous in the sense of transformation into oncoprocess. The main cause provoking the development of colloid cysts is iodine deficiency in the body, and heredity affects this endocrine pathology to a lesser extent. 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 with the accident at the Chernobyl Nuclear Power Plant, are also a provoking factor for many thyroid diseases.

In the initial stage, colloid nodes do not show clinical signs, formations up to 10 mm in size are not felt by man and in principle are not harmful to health. However, increasing nodes can impede the process of swallowing food, compress the esophagus, trachea, recurrent nerve endings of the larynx. Another typical sign of a growing node is excessive sweating, hot flushes, tachycardia, and periodic flashes of unjustified irritability, which is explained by an excessive release of hormones into the bloodstream (thyrotoxicosis).

Virtually all endocrinologists are unanimous that a colloid cyst of the thyroid gland does not need surgical treatment, for its supervision only regular monitoring and monitoring of the condition of the gland is necessary using ultrasound examination.

In clinical practice, a follicular cyst of the thyroid gland is defined as a follicular adenoma, which is much clearer and more accurate, since such a formation consists of a large number of tissue cells - follicles, that is, a rather dense structure that does not have a cavity in the cyst. Follicular adenoma is also rarely manifested 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 the sense of malignancy and is more often reborn into adenocarcinoma than a colloid cyst.

Follicular neoplasm is diagnosed in patients of any age - from child to adult, but most often in women.

Symptoms:

• Dense formation in the neck, which is well palpable, and sometimes visually noticeable.
• No pain on palpation.
• Clear boundaries of education (with palpation).
• Labored breathing.
• Discomfort in the neck.
• Sensation of a lump in the throat, squeezing.
• Frequent coughing.
• Sore throat.
• With a developed cyst - a decrease in body weight.
• Irritability.
• Increased fatigue.
• Sensitivity to temperature changes.
• Sweating
• Tachycardia.
• Increased blood pressure, pressure instability.
• Possible low-grade body temperature.

Diagnostics:

• Anamnesis, subjective complaints.
• Palpation.
• Ultrasound examination of the gland.
• If necessary - puncture and histological analyzes.
• Scintigraphic (radionuclide) study using a radio-indicator.
• Unlike colloidal formations, follicular adenomas are poorly amenable to conservative treatment, most often they are operated on.

Cyst of the right lobe of the thyroid gland

As is known, the thyroid gland in structure resembles “a butterfly, consisting of two lobes. The right side is slightly larger than the left, this is due to the fact that during fetal development, the right lobe of the thyroid gland is formed earlier, its follicles are formed more intensively, and the left ends its formation 10-14 days later. Perhaps this explains the high prevalence of cyst of the right lobe of the thyroid gland. As well as typical neoplasms associated with follicle expansion, the right-sided cyst is usually benign in nature and rarely grows to pathological dimensions. 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 symptoms:

• Uncomfortable squeezing in the neck.
• Feeling of a constant lump in the larynx.
• Difficult swallowing, breathing.

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

The cyst of the right lobe of the thyroid gland is well palpated when it increases by more than 3 millimeters as a solitary (single). For the diagnosis of such an education, as well as for multiple diffuse nodes, both ultrasound and a biopsy of cyst removal are performed for histological (cytological) analysis, if it has a size of 1 centimeter or more.

Right-sided cysts up to 6 millimeters are subject to conservative treatment and regular observation, the prognosis depends on what the histology will show. Even medication drugs are usually not required, just a certain dietary regime with the inclusion of seafood, iodine-containing dishes in the menu is sufficient. You also need to monitor the performance of TSH in the dynamics, every six months. In 80-90% of cases with timely detection of such formations, cysts are well treated with the help of diet or drug therapy and are not operated.

[1], [2]

Cyst of the left lobe of the thyroid gland

The left lobe of the thyroid gland - the lobus sinister can normally have a slightly smaller size, compared with the right, this is due to the anatomical structure of the gland. Cysts can develop both on both lobes and be unilateral, for example, on the left side. A cyst of the left lobe of the thyroid gland less than 1 centimeter is usually subject to dynamic observation and does not require any conservative, much less surgical treatment. With its increase, a puncture is possible, at which the cavity is emptied and a special preparation, sclerosant, is administered. This tool helps to "stick together" the walls of the cyst and prevents the recurrence of the accumulation of colloidal content in it. In addition, during the inflammatory, purulent process in the cyst, the puncture helps to identify the true causative agent of the infection, and to specify the antibacterial therapy. In cases where, after sclerotherapy, a cyst re-forms in the left thyroid lobe, an operation is shown - 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 excessively active, then the right lobe will be either normal or hypoactive. Thus, the cyst of the left lobe is not a complex, life-threatening disease and is a solvable problem in the sense of the functioning of the gland itself (TSH level) and a possible increase in size.

Diagnosed with a left-sided cyst standard:

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

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

[3], [4]

Cyst of the isthmus of the thyroid gland

Isthmus glandulae thyroideae - the isthmus on palpation is well defined, unlike the thyroid gland itself, which normally should not be visible or probed. The isthmus is a transverse, smooth, dense “cushion” 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 the reason for the examination by the endocrinologist to identify possible pathology, since it is this zone that is most dangerous in the sense of malignancy (oncological process).

A thyroid isthmus cyst is diagnosed as follows:

• Anamnesis, subjective complaints.
• Palpation of the isthmus, 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 entities 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 shown. If the biopsy reveals the benign nature of the tumor, that is, it is diagnosed as colloidal, the endocrinologist determines the treatment tactics, but today there are no drugs that could reduce or stop the growth of tumors. In cases when the cyst of the isthmus of the thyroid gland does not violate the basic functions, does not affect the hormonal background and does not manifest painful symptoms, it is subject to constant monitoring and monitoring.

The previously popular thyroxin is today recognized as insufficiently effective, in addition, its side effects often exceed questionable efficacy. Courses of radioiodine therapy are not practiced in our country, they are mainly used in foreign clinics, therefore, if a malignant character is suspected, its large size can be operated on.

[5], [6], [7]

Small cysts of the thyroid gland

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 dilated follicles identified by the histological method. It should be noted that the 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 tumors in the gland, exceeding 1.5-2 millimeters, are called cysts, that is, anechoic formations containing colloid. If the ultrasound shows a hypoechoic formation, it is diagnosed as a node, but specifying differentiation with such small sizes is possible only with the help of histology and Doppler sonography.

Small cysts of the thyroid gland often disappear on their own, subject to the iodine-containing diet, excluding the effects of thermal factors and psycho-emotional stress. The prognosis for such colloidal formations is favorable at almost 100%.

[8], [9]

Multiple cysts of the thyroid gland

Endocrinologists consider incorrect the expression “multiple cysts of the thyroid gland” as a diagnosis, rather it is not a clinical definition of the disease, but a conclusion of instrumental studies, which include ultrasound. The term polycystosis is, in principle, excluded from the diagnostic dictionary and is transferred to the category of definitions (definitions) of tissue changes in any organ - the ovaries, the thyroid gland, the kidneys. Multiple cysts of the thyroid gland are detected by ultrasound scanning as the initial pathological hyperplasia of the tissue structure in response to iodine salt deficiency. Most often - this is the first signal of a developing pathology of the thyroid gland, for example, struma - goiter. The main reason for this deformation is iodine deficiency, respectively, treatment should be directed to neutralizing the provoking factors - the impact of environmental, psycho-emotional, food strumogens and iodine replenishment. The so-called polycystic thyroid disease requires regular monitoring of its size, assessment of functioning, that is, the patient is simply under medical supervision and an ultrasound scan of the thyroid gland takes place once every six months. In addition, it is advisable to develop a special diet, diet, together with the doctor nutritionist, perhaps visiting psychotherapy sessions to restore emotional balance.

[10]

Thyroid cyst in children

Unfortunately, unfavorable environmental conditions, environmental pollution, unreasonable food, 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 develops during the prenatal stage, especially if the pregnant woman has a history of some form of endocrine disruption.

The cyst of the thyroid gland in children is quite rare, according to statistics, it is diagnosed only in 1% of the total number of functional or pathological changes in the organ. However, it is children's endocrine diseases that are considered the most dangerous in terms of malignancy, that is, possible transformation into cancer.

Anatomically, the thyroid gland in children differs from the structure of an adult organ, its weight is smaller, and its dimensions are somewhat larger. In addition, the child's lymphatic system and thyroid gland are more active because they are responsible for the production of growth hormones, protein synthesis, cardiovascular function, and many other functions.

Reasons for the development of thyroid cyst in children:

• HAT is a chronic autoimmune thyroiditis.
• Acute - diffuse, purulent or non-purulent thyroiditis.
• Traumatic damage to the gland as a result of a fall, blow.
• Iodine deficiency.
• Malnutrition.
• Bad environmental conditions.
• Hereditary factor.
• Pubertal period with hormonal disorders.
• Clinic tumors in adults is almost identical.

The symptoms that can manifest a benign formation are:

• The initial stage is asymptomatic.
• Perhaps a sore throat with a large amount of cysts.
• Sore throat.
• Dry, frequent cough without objective reasons.
• Difficulty swallowing food (dysphagia).
• Rapid breathing, often - shortness of breath.
• Perhaps a visual change in the shape of the neck.
• Capriciousness, irritability.

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

The greatest danger is a purulent cyst, which provokes hyperthermia, general intoxication of the body. Also, the sad statistic says that more than 25% of all detected neoplasms 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.

Diagnosis is similar to the adult screening plan:

• Collection of anamnestic information, including hereditary.
• Examination and palpation of the gland.
• Ultrasound of the thyroid gland.
• Puncture of the tumor.
• If you suspect a malignant form - a biopsy.

Treatment, which involves a thyroid cyst in a child, depends on the diagnostic results; it can be either conservative or operative. The prognosis for timely detection of benign lesions of a small size, as a rule, is favorable.

Thyroid cyst in adolescents

The actual problem is diseases of the thyroid gland, it concerns both the adult population and children, especially adolescents, whose age implies rapid growth, active work of the hormonal system. In addition, thyroid pathologies of the thyroid gland are becoming more common due to iodine deficiency, unfavorable ecological situation, which also affects the decline in the function and activity of the gland. Reduced production of thyroid hormones disrupts the normal development of the body in the pubertal period, alters metabolic processes, slows the growth and development of the central nervous system. Against the background of all factors provoking endocrine pathology, thyroid cyst in adolescents today is not uncommon. Most often, such neoplasms are detected at random or during routine dispensary examinations. About 80% of all pathologies are colloidal cysts, nodes. Despite the fact that this form of formations is considered quite favorable in the sense of a prognosis, benign, thyroid cancer in children and adolescents began to occur 25% more often than 15 years ago.

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

The diagnosis, which suggests a thyroid cyst in adolescents, is similar to the standards for examining the adult gland

• Examination, palpation of the lymph nodes, thyroid gland.
• Ultrasound gland.
• TAPB - fine needle aspiration biopsy.
• Blood test for TSH.
• Perhaps radioisotope examination.

The choice of method, method of treatment of a cyst depends on its nature, size, localization - left, right lobe, isthmus.

General recommendations for adolescents living in areas with a low level of iodine salts are also standard and are associated with the prevention of hypothyroidism, as the most frequently detected disease. Iodine intake for children over 12 years old is 100 µg 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 at registration in the consultation those or other violations in the work of the thyroid gland are identified. It is not necessary to write off the detected problems as hormonal changes due to pregnancy, it is better to be safe and undergo a full examination so as not to damage either yourself or the fetus, which needs a healthy maternal organism so much. Any disruption in the work of the thyroid gland, including a thyroid cyst and pregnancy are not well combined. First of all, in the sense of 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 constitutes a thyroid cyst.

Etiology, factors that can trigger the development of cysts, nodes, thyroid adenoma:

• Actually the fact of pregnancy as physiological changes in the body as a whole, in the hormonal systems and in the structure of the gland in particular.
• Lack of iodine salts.
• Inflammatory processes in the gland, thyroiditis.
• Labile, unstable psyche, stress.
• Heredity.
• Rarely - injuries of the thyroid gland.

A thyroid cyst and pregnancy can live quite peacefully if the education is small (up to 1 cm) and benign, as a rule, these are colloid cysts that are self-dissipating.

The clinic can be very diverse, in contrast to the symptoms of tumors in women who are not expecting a child. Future mothers are more sensitive, so they may notice some discomfort in the neck in the very early stages. Also among the signs of a developing cyst there may be an atypical timbre of voice - hoarseness, tickling, difficulty in swallowing even small pieces of food. All of these manifestations do not necessarily indicate that the cyst is large, rather, it is an indicator of the aggravated sensations of a pregnant woman.

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

Thyroid cysts are diagnosed in pregnant women as standard, but the percentage of early detection is much higher, this is due to the mandatory dispensary examinations and observation. Often, future mothers are completely in vain afraid of puncture, it is not only a way to accurately determine and confirm the goodness of tumors, but also to scleroticize the cyst in time so that it cannot increase further. Also positive information is the fact that the thyroid cyst and pregnancy are quite compatible and the diagnosed education cannot be the basis for termination of pregnancy. Cysts are subject to observation, as well as adequate iodine-containing medications and rest are prescribed to the woman. Formations of large size, which can significantly impair the functioning of the thyroid gland, operate only after delivery and in case of urgent need.

Consequences of a thyroid cyst

The prognosis and consequences of a thyroid cyst are directly related to diagnostic indicators and results. If the tumor is defined as benign, the prognosis is favorable in almost 100% of cases, however, it should be noted that the tumor may recur and require re-examination and treatment.

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

Fortunately, malignant cysts are extremely rarely diagnosed, and benign cysts are treated with the help of iodine-containing products, which are constantly monitored by an endocrinologist.

[11], [12], [13], [14]

Diagnosis of thyroid cyst

Diagnostic measures to identify pathologies of the thyroid gland should ideally be preventive, that is, dispensary and regular. However, most often cysts are accidental findings during examination for other diseases.

Diagnosis of thyroid cyst is carried out by the following methods and methods:

• Collecting history.
• Visual inspection of the patient.
• Palpation of the gland, lymph nodes.
• Ultrasound examination of the gland for the primary differentiation of cysts, adenomas, nodes.
• Puncture (fine-needle aspiration) to clarify the nature of the neoplasm, the type of tumor - a simple, yellowish-brown content, congenital cyst with transparent contents or purulent cyst.
• Perhaps simultaneous hardening (with puncture).
• Blood test for TSH, T3 and T4.

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

1. Cold knot as an indicator of possible oncology (iodine does not penetrate into the gland tissue).
2. Warm knot - spreads iodine injected into the tissue and cyst evenly.
3. Hot knot - active absorption of iodine salts as an indicator of a cyst, node.

• Computed tomography of the gland.
• Pneumography for suspected metastasis.
• Angiography.
• Possible laryngoscopy to assess laryngeal lesions.
• Bronchoscopy to assess tracheal lesions.

Ultrasound of the thyroid gland with a cyst is the second stage of diagnosis 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 with almost 100% accuracy helps to identify small nodes, cysts, adenomas or tumors.

Indications for ultrasound:

• Atypical shape of the neck, its deformation.
• Enlarged lymph nodes.
• Indicators of blood tests for TSH.
• Registration on pregnancy.
• Preparing for surgery.
• Violation of the menstrual cycle, hormonal failure.
• Monitoring the state of the thyroid gland.
• Persistent infertility.
• Disphagia.
• Excessive anxiety.
• Acceptance of hormonal drugs.
• Hereditary endocrine diseases.
• Occupational hazards associated with working in high radiation areas.
• Age changes - a climax.
• Routine inspection.

It is necessary to pay attention that practically all the listed reasons for examination can also be provoking factors for the development of a thyroid cyst.

What possibilities does and what indicators does ultrasound examination of the thyroid gland have in a cyst?

• The contours of the gland.
• The size of the lobes of the gland.
• The echogenicity of the tissue (thyroid).
• The location of the thyroid gland.
• Partition control.
• Evaluation of neoplasm structure.
• Definition of a form, quantity of cysts.
• Assessment of lymphatic drainage.
• Identify possible metastases.

How is the examination process going?

Scanning of the gland, and the identification of cysts, other formations is carried out in the prone position, the neck is smeared with a special gel that creates gliding and provides ultrasound conductivity. The procedure is absolutely painless and safe, its duration is short, depends on the state of the gland and the practical experience of the examiner. The patient is not required to prepare, but it is better to perform an ultrasound on an empty stomach in order to avoid vomiting during possible light pressure on the gland with a sensor.

A cyst having a size of no more than 1 centimeter, a thyroid cyst of 4 mm is a small formation that is detected both by ultrasound and by scintigraphy. Palpating such a cyst is almost impossible, so small it is. Cysts of small size can be both single and multiple, they do not give clinical symptoms and are not felt as uncomfortable. The only exception, which, however, is extremely rare, is a purulent cyst that can ache if you accidentally press on the neck. A thyroid cyst of 4 mm cannot be treated, it is detected during a routine examination, and further monitoring for an increase is possible. With timely detection and replenishment of iodine salts, such a tumor does not grow in size, moreover, colloidal small cysts tend to self-absorb. Some endocrinologists, in principle, do not consider cysts of 4 millimeters as education, considering it as a functionally altered follicle. However, if a small cyst is diagnosed, it must be monitored with regular ultrasound.

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

Puncture of the thyroid gland is prescribed for almost all types of cysts greater than 3 millimeters to avoid the risk of malignant cyst, which rarely happens, because a true cyst, that is, able to transform into a tumor, is considered a clinical "myth." There is no recovery period after puncture, the procedure is performed on an outpatient basis.

[15], [16], [17],

Thyroid Cyst Treatment

Treatment of a cyst of the thyroid gland depends on the identified pathology and can be conservative, operative, or requires regular monitoring without the use of any drugs. As a rule, the thyroid cyst is subject to dynamic observation in order not to miss the moment of its increase. The main effective treatment is puncture with aspiration and hardening of the cyst walls. Doctors use alcohol as sclerosing agents. During aspiration, the contents are not simply removed, but also sent for histological examination. If the cyst grows after the puncture, it recurs several times, an operation is indicated.

Small cysts that do not interfere with the work of the thyroid gland can be supervised with the help of thyroid hormone preparations. However, many doctors today are trying to avoid such appointments and try to control the cyst with iodine-containing diet, iodine preparations. Almost all cysts have a benign form and a favorable prognosis, but require periodic ultrasound scanning.

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

• Resection of the majority of the thyroid gland with bilateral large cysts.
• Hemistrumectomy - removal of one lobe of the gland.
• Total removal of the gland, surrounding tissues and lymph nodes in malignant tumors.
• Surgery for a cyst of the thyroid gland.

Surgical intervention is indicated in such cases:

• A large cyst that crushes the neck, the larynx, provokes suffocation.
• Cyst:
  • which causes dysphagia.
  • which deforms the neck - a cosmetic defect.
  • which upsets the hormonal balance.
  • which suppurate.
  • which is diagnosed as malignant.

The operation for a thyroid cyst is indicated for solitary tumors, which are diagnosed as nodular, as a rule, hemithyroidectomy is performed.

Cysts less than 10 millimeters are resected. Completely iron is removed in extreme cases, with malignancy of the neoplasm, metastasis, which is extremely rare in cystic forms.

Currently, endocrinologists are trying to treat cysts in low-impact ways, such as sclerotherapy, since a large surgical intervention is always accompanied by additional risks and complications.

Thyroid cyst removal

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

Just 10 years ago, almost 70% of operations were carried out without truly real, life-threatening rationales. As with any surgical intervention, removal of a cyst, thyroid gland is a test for the patient, in addition, accompanied by possible complications and consequences.

Currently, the removal of a cyst of the thyroid gland is possible only under strict indications that do not imply the choice of another method. The following methods are used as cyst removal methods:

• TAB - fine needle aspiration biopsy.
• Punctuation.
• Sclerosing
• Coagulation by laser.
• Surgical full operation.

What tests need to pass before removing a cyst?

• KLA - complete blood count.
• Blood for the presence or absence of hepatitis, HIV, sexually transmitted diseases.
• Blood on the TSH.
• Ultrasound gland.
• Punctuation.
• Biopsy.

An operation on the thyroid gland can be partial or complete, if the cyst is associated with an autoimmune process, a complete removal of the gland cannot be complete. There are modern technologies that allow to leave part of the structures - the laryngeal nerve, parathyroid glands. Removal of a large cyst takes place under general anesthesia, lasts no more than 1 hour, and the recovery process does not exceed 3 weeks. Colloid cysts do not operate, they are subject to dynamic observation.

Sclerotherapy of thyroid cyst

This is one of the ways to remove small cyst in a timely manner. Sclerotization is carried out by introducing into the cavity of a cyst a substance - a sclerosant capable of “sticking together” 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 subside, stick together and scar. The whole procedure is carried out under the control of ultrasound, a needle is led into the cavity of the neoplasm in order to aspirate the cyst contents.

The sclerotherapy of the thyroid gland is the suction of practically the entire colloid from the cavity, in the place of which the sclerosant is injected in a volume of from 30 to 55% of the removed fluid. Alcohol is in a hollow cyst no more than 2 minutes, then removed with a needle. The procedure is practically painless, but can cause burning sensations.

[18], [19], [20], [21], [22],

Treatment with alternative means of thyroid cyst

Alternative recipes in the treatment of thyroid cyst are the “past century”, as endocrinologists believe, but there are forms and types of formations that are well treatable in this way.

Treatment with alternative means involves the use of the following recipes:

• Zamanihi tincture - 20 drops per 100 milliliters of boiled chilled 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 insist on alcohol - a glass of young leaves for 500 milliliters of alcohol. Hold for 2 weeks, take 5 drops, drinking water three times a day - a month.
• Infusion of walnut leaves. 100 leaves pour half a liter of boiling water, hold for 30 minutes, drink strained broth during the day month. A walnut is a storehouse of iodine, which the thyroid gland is so lacking.
• It is good to make compresses around the neck of iodized salt (wrap in cloth).
• Grated raw beets, which also contain iodine, wrapped in cloth and applied to the neck.
• Honey compress can help in the treatment of thyroid cyst. Honey is mixed with rye bread, the resulting mass is applied to the place of cysts and left overnight.
• It is necessary to take flax oil - a teaspoon twice a day before meals for a month.
• It is believed that if you wear amber beads, then a cyst, thyroid gland nodes will not grow, and may even dissolve.

Nutrition with thyroid cyst

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

Nutrition for a thyroid cyst involves food, products, which contain iodine salts:

• All types of seafood - sea fish, shrimp, crabs, seaweed, squids, cod liver.
• Persimmon.
• Dates.
• Chokeberry.
• Prunes
• Feichoa.
• Black currant.
• Cherry.
• Beet (raw, boiled, baked).
• Eggplant.
• Radish.
• Tomatoes.
• Spinach.
• Walnuts.
• Garlic.
• Buckwheat.
• Herring.
• Leaf salad.
• Millet.

It is necessary to limit the use of such products (strumogens) with a diagnosed goiter:

• Peach.
• Cabbage (all kinds).
• Topinambur.
• Radish.
• Radish.
• Spinach.

You should not get involved in sweet dishes, smoked meats, fried meat, bacon, canned goods. Food should be salted with iodized or sea salt. You can regularly take a dietary supplement, which should be negotiated with your doctor.

[23], [24]

Thyroid cyst prevention

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

• Regular intake of the necessary daily intake of iodine salts.
• The use of iodized salt.
• Minimizing sun exposure, especially in summer.
• Careful attitude to physiotherapy procedures, they must prescribe a doctor.
• It should protect the neck from injury, hypothermia, as well as from overheating.
• You must regularly take vitamins that are not able to accumulate.
• Every six months should be examined - inspection, palpation, ultrasound.
• It is necessary to learn to cope with mental stress, to avoid stress.
• In cases when psycho-emotional stress is inevitable, plan relaxing exercises, attend psychotherapy sessions.
• Avoid prolonged exposure to direct sunlight.

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