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Lingual thyroid presenting after previous thyroglossal cyst excision.

Lingual thyroid is a rare lesion caused by maldescent of the thyroid gland. It is an important cause of a mass on the posterior third of the tongue, and may coexist with other developmental abnormalities such as thyroglossal cyst. The diagnosis is made by radioisotope scan. Treatment is indicated in the presence of symptoms and consists initially of thyroxine. Severe or unresponsive cases require complete excision through a lateral pharyngotomy. Hypothyroidism is common postoperatively, but may be avoided in some cases by transplantation of excised tissue. We present a case report and review of the literature.

Choristoma↗

Identification of papillary carcinoma in a thyroglossal cyst by fine-needle aspiration biopsy.

Papillary carcinoma was diagnosed in a fine-needle aspirate from a cystic upper-cervical midline lesion attached to the hyoid bone. Histological examination of the excised specimen verified the diagnosis. Carcinoma arising in thyroglossal cysts, though rare, should be considered in patients presenting with an anterior midline mass in the upper neck; fine-needle aspiration may be useful in the preoperative diagnosis.

Aged↗

[Thyroglossal cysts and fistulas].

We know that 2% of neck tumors are thyroglossal duct cysts. A retrospective review was carried out of 33 patients with thyroglossal duct remnants (22 cysts and 11 fistulas) who had undergone surgery at our ENT department from 1974 to 1979. Follow-up data were available from 29 patients and exceeded 1 year in every case. Attention was directed to the preoperative history of these lesions, their clinical presentation, anatomopathological and diagnostic findings, the nature of surgery performed, the complications of surgery, and the incidence of recurrence. In literature, surgery should be radical (Sistrunk) in order to avoid recurrence. At our ENT department surgery is performed following a scheme after which the extension of the operation varies to the preoperative findings. We found no recurrences in the follow-up group, neither in the group that received a radical operation (8), nor in the group that received a non-radical operation (21).

Child, Preschool↗

Pre-Gardner's syndrome, thyroglossal cysts and undifferentiated tumor of neural crest origin.

A child with a malignant undifferentiated adrenal medullary tumor of neural crest origin, removed at six months of age, was treated with chemotherapy and is alive without evidence of cancer after seven years. He developed osteomas of the skull, a thyroglossal cyst and has had one episode of gastrointestinal bleeding. A three-generation history of multiple colonic polyposis and colon cancer, osteomas, recurrent pancreatitis, and Wilms' tumor was elicited. One of three females in this family, with direct lineage from polyposis afflicted fathers, exhibited Gardner's Syndrome and Wilms' tumor. The constellation of tumors afflicting this family may represent an underlying defect of excessive cell proliferation affecting mesenchymal and neuroblastic tissue. These may be extracolonic conditions associated with Gardner's Syndrome.

Adrenal Gland Neoplasms↗

[Thyroglossal cysts].

We reviewed the records of 33 patients who underwent surgery for removal of a thyroglossal duct cyst at the Bordet Institute between 1970 and 1983. All patients had complete resection of a midline cervical lesion. In 27 cases the provisional diagnosis at presentation was confirmed by histological examination after surgery. The surgical procedure performed at the Bordet Institute and its results are analysed. We emphasize the need of resecting the central portion of the hyoid bone as well as the proximal tract of the thyroglossal duct. Twenty-six patients have been cured using this technique.

Adolescent↗

Tall cell variant of papillary carcinoma arising from a thyroglossal cyst: report of a case with diagnosis by fine needle aspiration cytology.

BACKGROUND: Papillary carcinoma arising from a thyroglossal duct cyst (TDC) is the most frequent malignancy arising from this embryologic remnant of the thyroglossal duct. The preoperative fine needle aspiration cytology (FNAC) of such neoplasms has rarely been cited. Approximately 170 TDC cases have been reported in the literature worldwide, diagnosed solely on histopathology. CASE: A 63-year-old woman presented with an anterior midline neck mass of years' duration. A hypodense cyst was located at the level of the hyoid bone. FNAC of the midline neck mass showed bloody, mucoid material and numerous atypical, elongated cells. The aspirated material was reported as "papillary carcinoma possibly arising from the thyroglossal duct," and the diagnosis was confirmed by histopathologic investigation on resection material. CONCLUSION: Tall cell variant is a rare variant of papillary carcinoma and has a poor prognosis. The differential diagnosis includes Hürthle cell lesions, oncocytic papillary thyroid carcinoma and Warthin-like papillary carcinoma.

Biopsy, Fine-Needle↗

Anterior lingual thyroglossal cyst: antenatal diagnosis, management, and long-term outcome.

OBJECTIVE: To describe the long-term outcome of a large anterior lingual thyroglossal duct cyst, diagnosed antenatally by ultrasound that completely obstructed the oral cavity and had almost completely replaced the anterior two-thirds lingual musculature. METHODS: Longitudinal observation. RESULTS: Anticipated airway obstruction at birth did not occur. Complete cyst removal occurred at day 2 of life with a rim of lingual muscle observed present only on the left side. Complete and safe oral feeding was achieved by day 11 of life. Progressive muscle mass development and function with mild asymmetry was observed during sequential assessments. Vigorous speech therapy was started at age 7 months achieved 80-100% intelligible speech with minimal misarticulations at age 33 months. CONCLUSION: This case demonstrates the remarkable compensatory ability of the tongue to achieve almost normal function with minimal anterior musculature that is critical to deglutition and articulation. Early speech therapy appears key to improving functional outcomes of speech. A strong central nervous system basis for suckle development is suggested by the rapid development of a safe and effective suckle and swallow soon after cyst resection and in spite of in utero tongue fixation.

Humans↗