Management Strategies for Thyroid Colloid Cysts

Abstract

Background: Thyroid colloid cysts are common benign thyroid lesions that are frequently detected incidentally during ultrasonographic examination. Although most cysts remain asymptomatic and require only observation, intervention may be necessary in patients with compressive symptoms, cosmetic concerns, progressive enlargement, or suspicious imaging features. Simple aspiration is commonly used as an initial treatment; however, it is associated with high recurrence rates due to reaccumulation of cystic fluid. Minimally invasive techniques, including ethanol ablation, radiofrequency ablation, and intralesional triamcinolone injection, have therefore emerged as alternatives to repeated aspiration and surgery. Triamcinolone has anti-inflammatory, antiproliferative, and antifibrotic effects that may reduce cyst volume and limit fluid recurrence by decreasing capillary permeability, suppressing epithelial proliferation, and promoting fibrosis of the cyst wall. Available evidence suggests that intralesional triamcinolone injection is a safe, effective, and minimally invasive treatment with few adverse effects and no consistent significant impact on thyroid function. Nevertheless, further large-scale randomized controlled studies are required to establish standardized treatment protocols and assess its long-term efficacy. Thyroid colloid cysts are benign degenerative lesions that usually require conservative follow-up. Symptomatic or recurrent lesions may require aspiration, ablation, or surgical treatment. Because recurrence after simple aspiration is common, increasing attention has been directed toward minimally invasive therapies, particularly intralesional triamcinolone injection, as a potential method for reducing cyst size, relieving symptoms, and preventing recurrence while avoiding the risks of surgery.