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Benign Thyroid Cyst — RACP Adult Medicine MCQ

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HardEndocrinologyBenign Thyroid CystRACP Adult Medicine

A 50-year-old has an incidental 1.2-cm purely cystic thyroid lesion with no solid component, mural nodule or suspicious node and a normal TSH. What is the appropriate management?

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Correct answer: D — No diagnostic FNA; reassure and review only if symptoms or sonographic features change

The best answer is “No diagnostic FNA; reassure and review only if symptoms or sonographic features change”. A purely cystic lesion without a solid component is essentially benign and does not meet FNA criteria. Aspiration may be offered for recurrent compressive symptoms, but diagnostic cytology, hormone suppression, ablation and surgery are not justified by size alone. New solid tissue or suspicious nodes would change the assessment.

Reference: Australian Prescriber: Investigating thyroid nodules: https://australianprescriber.tg.org.au/articles/investigating-thyroid-nodules.html