Cancer in Cystic Lesions of the Thyroid

Abstract

• We reviewed the records of 341 patients who underwent thyroidectomy for the suspicion of cancer between 1975 and 1980. Cancer of the thyroid was found in 14% of them. Although cysts of the thyroid (pathologic finding of a fluid-filled cavity greater than 1 cm in diameter) were encountered in 35% of the patients, cysts were similarly distributed among patients with benign conditions (27%) or with cancer (33%). Most of the thyroid cysts in patients with carcinoma measured 2 to 4 cm in diameter. The cancer was found within the cystic cavity. The cysts in patients with cancer appeared to originate from necrosis of the tumor. B-mode ultrasonography was not reliable in differentiating cystic and solid lesions. The demonstration of the cystic nature of a thyroid nodule does not rule out the diagnosis of cancer of the gland. (Arch Surg 1982;117:1020-1023)