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Updated: Aug 8, 2026
Endoscopic Approach for Colloid Cyst Resection
Published on: May 23, 2025
[Approach to cytologically-benign recurrent thyroid cysts]
Vicente Pla-Martí1, Cristina Fernández-Martínez, Antonio Pallas-Regueira
1Servicio de Cirugía General y del Aparato Digestivo, Hospital de Sagunto, Sagunto, Spain. vplamarti@yahoo.es
Introduction:
The aim of this study was to determine the incidence of carcinoma in cytologically-benign recurrent thyroid cysts and to evaluate the surgical indications in these patients.
Patients And Method:
We reviewed all patients undergoing thyroid surgery between January 1992 and December 2002 for cytologically-benign solitary or dominant cystic nodules in multinodular goiter that recurred after aspiration. Mixed nodules were excluded.
Results:
Thirty-four patients (29 women and five men) with a mean age of 43 years (18-76) underwent surgery. Seventy-five percent were solitary nodules and 25% were dominant nodules within a multinodular goiter. The mean number of fine needle aspirations with complete drainage was 2.3 (2-3) per patient with hemorrhagic aspirate in 35%. Total thyroidectomy was performed in multinodular goiters and lobectomy with isthmectomy in solitary nodules. Intraoperative biopsy revealed benign lesions in 91% and was inconclusive in the remainder; no cases of carcinoma were identified. Definitive pathologic findings revealed the nodule to be a papillary carcinoma in 3 patients (8.8%) and occult papillary carcinoma separate from the cyst in 4 patients (11.8%). In all these patients intraoperative biopsy showed benign disease. The risk of malignancy was higher in cysts larger than 3 cm (23% vs 0%; p<0.05).
Conclusions:
Given the incidence of carcinoma, surgical resection should be considered in recurrent cystic thyroid nodules, especially in those larger than 3 cm, regardless cytological study.
