How many times should a thyroid cyst be aspirated if it reaccumulates fluid?
Purely cystic nodules are most often benign, and FNA is not indicated for diagnosis. Aspiration may be performed if a cyst is large and symptomatic.
If aspirated, the cyst fluid should be sent for cytology. Recurrence of thyroid cysts occurs in > 50%; recent controlled studies have shown that aspiration followed by ethanol injection has a higher success rate compared with aspiration alone.
If the cyst recurs after a second aspiration, and it is still symptomatic, surgical excision may be considered