Endocrinologists consider the cystic thyroid lesions, present in 40% of thyroid nodules, as the least indicated ones for surgical therapy. Thirty-one patients with cystic thyroid nodules were nevertheless selected for surgery in our clinic based on nodule size (> 2 cm in diameter), their growth rate, clinically subjective phenomena or aesthetic complaints, but mainly for incomplete decompression or recurrence after repeated fine-needle aspiration (16 cases). Ultrasonography provided a correct characterization of cystic lesions and of their coexistent pathology. Patient demographics included 5 males and 26 females, aged between 14 and 61 years (mean age: 49.6). Three cases were simple cysts, 27 were degenerative benign colloid nodules or adenomas, but one case proved to be a papillary thyroid carcinoma. Cystic lesions contained serous, viscous and, in most cases, sanguine fluid. Three simple cystectomies, 22 (sub)total lobectomies and 6 subtotal or near total thyroidectomies were performed without any complications. Histology revealed a benign outcome in all cases, except the millimetric papillary carcinoma discovered in the capsule of one cyst. Few cases controlled over time revealed no relapses or other complications. Based on our experience, surgery appears to be safe and effective, so that it may remain a useful alternative treatment of cystic thyroid lesions, especially in cases of repeated failures of fine-needle aspiration-destruction concurrent with the suspicion of a coexisting malignant component.
Keywords:- fine-needle aspiration
- surgery
- thyroid cystic lesions