title: [Approach to cytologically-benign recurrent thyroid cysts].
abstract: BACKGROUND
  The aim of this study was to determine the incidence of carcinoma in cytologically-benign recurrent thyroid cysts and to evaluate the surgical indications in these patients.
  
  
  METHODS
  We reviewed all patients undergoing thyroid surgery between January 1992 and December 2002 for cytologically-benign solitary or dominant cystic nodules in multinodular goiter that recurred after aspiration. Mixed nodules were excluded.
  
  
  RESULTS
  Thirty-four patients (29 women and five men) with a mean age of 43 years (18-76) underwent surgery. Seventy-five percent were solitary nodules and 25% were dominant nodules within a multinodular goiter. The mean number of fine needle aspirations with complete drainage was 2.3 (2-3) per patient with hemorrhagic aspirate in 35%. Total thyroidectomy was performed in multinodular goiters and lobectomy with isthmectomy in solitary nodules. Intraoperative biopsy revealed benign lesions in 91% and was inconclusive in the remainder; no cases of carcinoma were identified. Definitive pathologic findings revealed the nodule to be a papillary carcinoma in 3 patients (8.8%) and occult papillary carcinoma separate from the cyst in 4 patients (11.8%). In all these patients intraoperative biopsy showed benign disease. The risk of malignancy was higher in cysts larger than 3 cm (23% vs 0%; p<0.05).
  
  
  CONCLUSIONS
  Given the incidence of carcinoma, surgical resection should be considered in recurrent cystic thyroid nodules, especially in those larger than 3 cm, regardless cytological study.
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital de Sagunto, Sagunto, Spain. vplamarti@yahoo.es
authors.forename: Vicente
authors.initials: V
authors.lastname: Pla-Martí
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernández-Martínez
authors.forename: Antonio
authors.initials: A
authors.lastname: Pallas-Regueira
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Rodríguez-Carrillo
authors.forename: Alberto
authors.initials: A
authors.lastname: Ibáñez-Arias
authors.forename: Carlos
authors.initials: C
authors.lastname: Flors-Alandí
authors.forename: José Vicente
authors.initials: JV
authors.lastname: Roig-Vila
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003560:Cysts / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013959:Thyroid Diseases / Q000150:complications* / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000150:complications* / Q000453:epidemiology* / Q000601:surgery