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PubMedDate not supplied

Thyroglossal duct cyst: an infrequently considered diagnosis in pediatric patients with anterior neck masses.

OBJECTIVE: To describe a pediatric patient with an anterior neck mass and discuss the evaluation and treatment. METHODS: We present a case report and a discussion of the differential diagnosis of anterior cervical masses. The workup and therapy for an anterior neck mass, which was a thyroglossal duct cyst, are reviewed. RESULTS: A thyroglossal duct cyst in pediatric patients is an uncommon finding. For establishing a correct diagnosis, surgical confirmation is necessary. Identification is important because of the high incidence of misdiagnosis, recurrent infections, inadequate treatment, and possible neoplastic change. CONCLUSION: A thyroglossal duct cyst should be included in the differential diagnosis of an anterior neck mass. Recommended treatment consists of surgical removal of the cyst, the entire thyroglossal duct tract, and the central portion of the hyoid bone.

Journal Article↗
PubMedDate not supplied

[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↗
PubMed2002

[Intra-laryngeal ectopic thyroid tissue. Report of one case and review of the literature].

A Ectopic thyroid is any thyroid tissue not located in his normal anatomic situation. There have been described four general groups within the upper aerodigestive tract: lingual, sublingual, thyroglossal and intralaryngotracheal. Intralaryngotracheal thyroid tissue is rare and constitute 7 per cent of all intratracheal tumours, and it represents a problem of diagnosis and management. The controversy about the genesis of this tumours remains. There are two established theories: "the malformation theory" and "the ingrowth theory". These tumours affect more frequently adult female. Intralaryngotracheal thyroid have been mainly reported on the posterior-left wall of the trachea. The most common clinical feature is stridor due to progressive upper airway obstruction. Up to 75% of the intralaryngotracheal goiters are associated with and external goiter. This paper reports a case of ectopic subglotic thyroid in a 42 year-old-female. The embryology, diagnosis and management of this tumours are discussed.

Adult↗
PubMed1991

Anatomical reconstruction of the thyroglossal duct.

The high postoperative recurrence rate of the thyroglossal duct cyst is well known. Since Sistrunk's operation was used, the recurrence rate was remarkably reduced, but the anatomical description of the thyroglossal duct through the entire tract has not been clarified in detail. For a more accurate anatomical understanding of the thyroglossal duct, 10 specimens obtained from Sistrunk's operation were studied using histological reconstruction, and a common running pattern of the thyroglossal duct was found. The cyst is usually located caudal to the hyoid bone mostly at the midline. The duct extends upward from the cyst ventral to the hyoid bone, with many or a few branches and secretory glands. These ducts or branches merge into a single duct at the level of the cranial portion of the hyoid bone. However, as it leaves the hyoid bone and approaches the foramen cecum, a single duct spreads out into many ductuli like the tip of a broom, which communicate with many secretory glands. There were three cases in which the duct was found behind the hyoid bone, but in no case did the thyroglossal duct run through the back of the hyoid bone. The duct behind the hyoid bone was recognized as a branch from the main duct in the dorsal direction. It ascended to the dorsal surface of the hyoid bone and terminated blind. These findings emphasized the importance of Sistrunk's operation to prevent a recurrence.

Child↗
PubMed1985

Branched and polycystic thyroglossal duct anomaly.

An unusual thyroglossal duct anomaly characterized by a branched tract terminating in two separate cysts is described. The patient presented with a long-standing fistula following previous incomplete excision. Thyroglossal cysts are common congenital anomalies (Moussatos and Baffes, 1963; Allard, 1982), which do not usually present any diagnostic difficulty. However, they may sometimes present with unusual clinico-pathological features. In this report we describe a branching and polycystic thyroglossal duct abnormality occurring in a young woman with a history of previous surgery for a midline cervical mass.

Adult↗
PubMedDate not supplied

Ultrasound characteristics of thyroglossal duct anomalies.

The purpose of this study was to determine the value of ultrasound examination in the diagnosis of thyroglossal duct anomalies. The ultrasound and palpation findings in 24 patients with a thyroglossal duct anomaly were reviewed. Cysts, tracts and ectopic thyroid tissue appeared to produce a characteristic ultrasound pattern in most cases. This study includes 5 patients with non-symptomatic lesions which were detected at ultrasound examination. The necessity of performing a radionuclide scan prior to surgery for a thyroglossal duct anomaly is reconsidered in view of the diagnostic power of ultrasound in thyroid disease.

Biopsy, Needle↗
PubMed1999

Presentations of thyroglossal duct cysts in adults.

The thyroglossal duct cyst is the most common congenital neck mass, resulting from persistence and dilatation of remnants of an epithelial tract formed during migration of the thyroid during embryogenesis. Approximately 7% of the population has thyroglossal duct remnants. Although thyroglossal duct cysts generally present clinically in children, it is important to understand that the lesion can present in adults as well, sometimes much later in life. Incidental carcinoma of the thyroglossal duct cyst is rare, but is more likely to occur in adults than children. Between 1991 and 1998, 11 cases of thyroglossal duct cysts were seen in adult patients at Georgetown University Medical Center, including 2 cases containing papillary carcinoma. This report discusses their clinical presentations and management.

Adult↗
PubMed2003

Papillary carcinoma of the thyroglossal duct cyst in childhood.

Thyroglossal duct carcinoma is a rare malignancy that is usually diagnosed postoperatively. Approximately 150 cases have been reported in the literature. Eighty-five percent of these were papillary carcinomas. Controversies exist concerning its nature and treatment. In this report, we present an 11-year-old boy with an anterior cervical cystic mass originating in the thyroglossal duct. After a primary Sistrunk procedure, the cyst and tract extending to the foramen caecum at the base of the tongue in continuity with the midportion of the hyoid bone were resected. Histopathologic study demonstrated a papillary carcinoma. After 4 months of follow-up, the patient is asymptomatic without any evidence of recurrence. The clinical and histopathological features and therapeutic options are discussed.

Carcinoma, Papillary↗
PubMed1979

[Remnants of the thyroglossal duct. A histological study].

This study was undertaken in order to find out the frequency of thyroglossal duct remnants and to specify the relationship between this tract the hyoïd bone. The remnants having undergone cystic pathology refer to tracks edged with an epithelial lining which can be various, associated or isolated, types. Thyroïd follicles may be annexed to this track, in or out of its cystic part. The systematic study of 23 hyoïdal and sub hyoïdal regions of adults exempt of any pathologic remnants allows one to find tracks in 13 cases, that is in every other case. This frequency is higher than the one normally described. These remnants always refer to some thyroïd follicle islands and rarely to an epithelial track. Furthermore, we can sometimes observe the frankly intra hyoïdal situation of the thyroid tissue. This last location is discussed according to embryologic data.

Adolescent↗
PubMed1986

Is the treatment for thyroglossal duct cysts too extensive?

From 1970 to 1985, 64 patients underwent surgical management for thyroglossal duct cysts at the University of Oklahoma Health Sciences Center. Their ages ranged from 1 to 63 years with a mean of 12.4 years. Ninety-one percent of the patients were available for follow-up. All patients underwent one of three forms of treatment: the classic Sistrunk operation, a modified Sistrunk operation, or excision of the cyst only. Eleven percent had undergone a previous procedure. The majority of patients were found to have a cyst in the midline at the level of the hyoid bone. Eighty-eight percent of the patients underwent excision of the midportion of the hyoid bone. There were no postoperative deaths and the perioperative complication rate was 20 percent, the majority being wound-related. All recurrences took place within 4 months of operation. Factors that appeared to be associated with an increased risk of complications and recurrence included young patient age (less than 10 years), rupture of the cyst at the time of operation, infection, and failure to excise the midportion of the hyoid bone and the suprahyoid tract. One patient was found to have a mixed papillary and follicular carcinoma in the thyroglossal duct. We support the original premise of Sistrunk that "the cure of thyroglossal cyst are unsuccessful unless the epithelium-lined tract, running from the cyst to the foramen cecum is completely removed," including the hyoid bone.

Adolescent↗
PubMed1984

The problem of recurrent thyroglossal duct remnants.

The removal of a thyroglossal duct or sinus is a common pediatric surgical operation. It has been taught that if the duct remnant is removed down to and including the middle third of the hyoid bone, the "correct" operation has been done. The three authors have an experience totaling over 60 years in pediatric surgery during which time they operated on 270 thyroglossal duct cysts and sinuses. In this group were 27 recurrences of which three belonged to the authors. Most recurrent thyroglossal duct remnants were found to have the middle third of the hyoid bone still in place, and with its removal the patients were cured. However, during this period of time, there were thyroglossal duct cysts and sinuses which recurred in spite of the "correct" surgical procedure having been done. These patients had all been operated on between three and five times thus creating a difficult and unusual problem. The solution to these recurrent thyroglossal duct cysts and sinuses were deeper excisions to remove residual tracts deep to the previously removed hyoid bone, and/or wider excisions to excise previously missed respiratory epithelial remnants which deviated laterally from the midline. The latter tissue was found to be a more centrally directed branchial cleft sinus.

Adolescent↗
PubMed1981

Asymptomatic mass of the anterior portion of the neck.

A case is reported in which a thyroglossal duct cyst was removed from the anterior portion of the neck of a patient. This lesion may occur after an upper respiratory tract infection. Treatment consists of complete removal of the entire cyst and tract. Without extensive surgery, recurrence can be expected.

Adult↗
PubMed1960

The isolation and identification of Haemophilus spp, from unusual lesions in children.

From a high proportion of children sent to hospital H. influenzae can be isolated if suitable culture media are used. A number of H. influenzae strains were isolated from unusual sites, such as (1) blood cultures after tonsillectomy or tonsillotomy in five cases; (2) urine or the urinary tract in eight cases; (3) the lumen of appendices removed at operation in 11 cases (4%); (4) osteomyelitis or pyarthrosis in six cases; (5) miscellaneous infections including two perianal abscesses, three cases of paronychia, one infected thyroglossal cyst, and several skin infections.It is suggested that infections of the skeletal system and the urinary tract arise from haematogenous spread of H. influenzae, as demonstrated by positive blood cultures after tonsillectomy and in two cases of skeletal infection. Infection of the appendix, perianal abscesses, paronychia, and skin infections probably arise by the direct route, either by immediate contact or by passage of viable organisms through the alimentary canal.

Abscess↗