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24 YO make with 5mm thyroid cyst, concerning or no big deal?

A couple months back I had an ultrasound for lymph nodes in my neck, they incidentally found a “5mm cystic lesion” on my thyroid, now the drs weren’t concerned but from what I understand whenever a man, especially young, has one of these it has a 1/3 chance of being cancer? Or is that not correct?

Another ultrasound the tech did tell me it appeared completely fluid based. All thyroid tests were normal. I do have a family history of thyroid disorders with the women on my mothers side.
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Hi Spartan114,

If your thyroid legion is completely fluid filled, then it is a cyst and usually benign.   Cysts can also be aspirated, especially if they are large and are impeding other structures in your neck (like your trachea or esophagus) or causing pain or discomfort.  Sometimes they can grow in size rapidly since they are fluid filled (unlike solid thyroid nodules which usually grow very slowly).  

A fine needle biopsy on a cyst probably won't yield many cells if it is fluid filled, some thyroid nodules have solid and cystic components and those do need to be biopsied, but it doesn't sound like that is your case.

If your cyst isn't causing pain and the pathologist has described it as completely fluid filled, there is a good chance your doctor will recommend just leaving it alone and possibly doing follow-up ultrasounds (at 6 months or a year) to see if it has changed in size.  Since it is only 5mm, this is pretty small and they might not recommend draining it.  Even if it was a solid thyroid nodule (which still has a low probability of being cancerous), most doctors won't recommend a biopsy until the nodule is at least 1 cm (10 mm).

If your family history of thyroid disorders includes medullary thyroid cancer, I would definitely tell your doctors about that because medullary thyroid cancer is rare and often hereditary.  Otherwise, I think just monitoring the cyst and seeing if it changes in size is a good approach.

I don't know percentages off the top of my head, but I know when men find nodules it is often more likely to be cancerous, like you said.  A lot of factors come in to play with that.  Lots of people have thyroid nodules (up to 80% of all people) and most will never know about it because there is no reason for neck ultrasound, CT, Xray, etc.  A lot of time nodules are only discovered when they reach a large size that is easily felt by doctors or can be seen as bulge on the neck, and nodules larger than 2 cm are more likely to be cancer than if they are smaller than 2 cm.  Since you have a cyst, and it is small, your chance of cancer is at a much lower risk than someone who walks in with a 4 cm solid nodule.

I'm sorry you have to go through this - I know finding thyroid nodules and cysts can be very scary.  It sounds like you have a cyst, which is usually benign and not something you need to worry about, but monitoring it to see if it changes in size is probably a good idea.
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The note about it on ultrasound only said ‘incidental finding of a 5mm cystic lesion, this is almost certainly bening’

That’s all that was said, when I asked another ultrasound tech who was looking at it (literally while she was looking at it under the ultrasound) if it was purely fluid filled and she said yes, so I’m assuming it was. They are following up at one year however.
Good, that sounds like it is a benign cyst and it is good they want to follow up in a year.  (I don't think a benign cyst would change in to cancer, but it might change size or it might disappear completely on its own).

Take care.
Avatar universal
You should have at least a fine needle biopsy with pathology by Endocrinologist before they can say it's nothing.
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I did see an Endo to follow up on it and she said she wasn’t concerned in the slightest given it was completely fluid filled.
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