From January 1991 to June 1992, we managed 55 cystic thyroid nodules with operation and/or TSH suppression and repeated needle aspiration. The age was 40 and the size was 3.3cm on average, 49 were and 6 were men. Each nodule was confirmed as
cystic
mass
when containing more than lcc of fluid content by aspiration or revealing as cystic dominant by ultrasonography After treatment with the above method for 3 months, the sized of the nodules were evaluated.
Fifteen nodules were promptly operated without TSH suppression due to their large sizes, suspicion of malignancies, hot nodule on nucleolide scan, and avidities for operation of the patients, but there was no malinancy in them.
Forty patients were managed with TSH suppression and repeated needle aspiration at 2 or 4 weeks interval. Thirteen nodules were operated due to their poor-responsiveness to conservative management. Only one malignancy was reveled in them(3%).
Twenty seven patients were managed with TSH suppression and needle aspiration only. All the nodules decreased in size at least by half during their suppression period. In 7 of them, the cystic lesions had completely collapsed to terminate the
treatment.
As a result, 27 of 40 had efficacy on conservative management(67%).
On conclusion, because of their low malignancy incidence and good effect of conservative treatment, cystic thyroid nodules had better be managed by TSH suppression and aspiration initially. It would be not too late to perform thyroidectomy after
sufficient conservative treatment.
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