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PubMed1996

Thyroglossal duct cysts: diagnostic criteria by fine-needle aspiration.

OBJECTIVE: To document the cytologic diagnostic criteria of fine-needle aspirations of thyroglossal cysts. DESIGN: Midline cervical masses were studied by fine-needle aspiration, and those 11 thyroglossal cysts that were resected served as a baseline for the evaluation of aspirates from 33 similar lesions that were not removed. SETTING: Physicians' offices, hospital outpatient clinics, and the aspiration service of a university department of pathology. PATIENTS: Forty-four patients noting a mass in the anterior neck or found by physicians to have such a mass. INTERVENTIONS: Fifty-one aspirations (second aspirates in seven patients); surgical removal of the cysts in 11 patients. MAIN OUTCOME MEASURES: Aspirates were examined for cells, other particulate matter, and any extracellular material in the background. RESULTS: Smears from thyroglossal cysts are low in cellularity, and inflammatory cells are more numerous than epithelial cells. CONCLUSIONS: Fine-needle aspiration contributes to an accurate preoperative diagnosis of thyroglossal cysts, allowing a Sistrunk procedure to be performed in these patients rather than an inappropriate local resection.

Adenoma↗

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↗

PubMed2005

Thyroglossal duct cysts: a consideration in adults.

Thyroglossal duct cysts (TDC) are one of the most common pediatric midline neck lesions. Although they are present from birth, they usually become symptomatic in early childhood as a mass or draining sinus. Infection and abscess formation are frequent complications due to a communication between the cyst and the mouth with subsequent contamination by oral flora. We present a case of a 37-year-old male who presented with a newly symptomatic thyroglossal duct cyst. The patient presented to the infirmary with pain in the anterior neck particularly with swallowing. A midline mass was visible and palpable on examination. Subsequent neck exploration revealed a thyroglossal duct cyst filled with purulent material. Although uncommon in adults, thyroglossal duct cysts should be a part of the surgeon's differential diagnosis when presented with a neck mass. One should remember that an infected neck mass is the common presentation of thyroglossal duct cysts in adults, and the appropriate diagnostic studies need to be performed in order to best determine the diagnosis. Once diagnosed, the TDC is best treated using the Sistrunk procedure to limit recurrence.

Adult↗

PubMed2003

Intrathyroidal thyroglossal duct cyst presenting as a thyroid nodule.

A 50-year-old woman presented with a lateral neck swelling, clinically indistinguishable from solitary thyroid nodule. A right hemithyroidectomy was performed and microscopy revealed an intrathyroidal thyroglossal cyst. Intrathyroidal thyroglossal cyst should be considered in the differential diagnosis of a thyroid nodule.

Diagnosis, Differential↗

PubMedDate not supplied

Large thyroglossal duct cyst with laryngeal extension.

BACKGROUND: A thyroglossal duct cyst typically presents as a long-standing neck mass that becomes symptomatic when inflamed. Hoarseness is an uncommon complaint, and its association may suggest encroachment on and destruction of the larynx. Following removal of the cyst with the Sistrunk procedure, the larynx may need to be reconstructed. METHODS: A case is reported of a patient who was initially seen with hoarseness and a long-standing midline neck mass. Computed tomography (CT) demonstrated a large cystic neck mass that eroded the thyroid cartilage and encroached on the pre-epiglottic space and right paraglottic space. Although the clinical impression was that of laryngeal neoplasm, the CT diagnosis was that of a cyst. At surgery, a thyroglossal duct cyst was found and successfully removed with the Sistrunk procedure. Because the thyrohyoid membrane and thyroid perichondrium were preserved, the glottis did not require reconstruction. This case is presented and the literature of thyroglossal duct cysts that extend into the larynx is reviewed. CONCLUSIONS: The clinical and radiographic criteria that suggest encroachment of a thyroglossal duct cyst on the larynx are reviewed. The management and indications for laryngeal reconstruction are discussed.

Adult↗

PubMed1992

Squamous cell carcinoma arising in a thyroglossal duct cyst.

Carcinoma arising in a thyroglossal duct cyst is a rare event, occurring in less than 1% of abnormalities of the thyroglossal duct. To date, there have been approximately 100 cases reported, with papillary carcinoma accounting for the vast majority. Squamous cell carcinoma, on the other hand, is an even rarer event. Its clinical course in the elderly, consisting of recurrent drainage and suppuration, may distinguish it from other neoplastic conditions of thyroglossal duct cyst. We present a 65-year-old man with squamous cell carcinoma in a recurrently discharging thyroglossal duct cyst to illustrate important distinguishing clinical features of this condition.

Aged↗

PubMed2005

Imaging for thyroglossal duct cyst: the bare essentials.

Thyroglossal duct cyst is the most common congenital cyst in the head and neck, and imaging features have been well documented in the literature. However, there are several practical important points to bear in mind during preoperative imaging, which are often overlooked. This review aims to summarize the imaging findings and emphasize important points for trainees and radiologists, particularly those who may encounter this lesion infrequently.

Adult↗

PubMedDate not supplied

Thyroglossal duct cysts in the elderly population.

Thyroglossal duct cysts may present at any age. However, only rarely do they first present in elderly patients. We outline a series of thyroglossal duct cysts in elderly patients at John Peter Smith Hospital, Fort Worth, TX. There appears to be a remarkable rate of malignant transformation noted in this subset of the population. We would therefore suggest early and definitive removal of all suspected thyroglossal duct cysts presenting in elderly individuals.

Aged↗

PubMed2006

Imaging case study of the month. Thyroglossal duct cyst with intralaryngeal extension.

OBJECTIVES: Thyroglossal duct cysts with intralaryngeal extension are rare. We present only the 10th reported case in the literature. METHODS: The clinical presentation, diagnosis, and treatment of the patient are reviewed and summarized. The uniqueness of the case, as well as the diagnostic and treatment pitfalls of this subgroup of patients, is presented. RESULTS: Our patient, at 76 years of age, is the only woman and the oldest person reported to have had a thyroglossal duct cyst with intralaryngeal extension. CONCLUSIONS: Intralaryngeal extension should be considered when there is hoarseness, dysphagia, or dyspnea associated with a thyroglossal duct cyst. Office laryngoscopy and computed tomography make the diagnosis. Care must be taken with airway management and intraoperative dissection for good outcomes.

Aged↗

PubMed2002

[Papillary carcinoma of the thyroglossal duct cyst: a case report].

The thyroglossal duct cyst is the most common anomaly in thyroid development. To date, approximately 250 cases have been reported, the majority being papillary thyroid carcinomas. In most cases the diagnosis is established only after excision of a clinically benign thyroglossal duct cyst. Controversies exist in relation to a rational and effective therapeutic approach. A further case of thyroglossal duct papillary carcinoma affecting a 52 years-old man is presented to highlight the clinicopathological features of this condition. FNAC resulted false negative. Surgery consisted in a Sistrunk procedure, followed by total thyroidectomy and central lymphectomy after definitive histological diagnosis. In view of the prolonged course of papillary carcinoma, long-term follow-up is mandatory.

Carcinoma, Papillary↗

PubMed2003

Thyroglossal duct cyst in hyoid bone: unusual location.

An atypically sited thyroglossal cyst in a 69-year-old woman is described in this report. The cysts may be located in the intralingual, suprahyoid, thyrohyoid or suprasternal region. The intrahyoid location is rare. The diagnosis was confirmed by computed tomography (CT). Surgical procedure should be indicated in intrahyoid thyroglossal duct cyst cases.

Aged↗

PubMed2006

Thyroglossal duct cyst: an unusual presentation.

Most thyroglossal duct cysts are located at or very close to the midline. They generally manifest as painless neck swellings, and they move on protrusion of the tongue and during deglutition. We describe a case of thyroglossal duct cyst that was unusual in that the cyst was located far from the midline, it did not move on protrusion of the tongue, and it was associated with symptoms of dysphagia and extensive neck swelling that mimicked a colloid goiter

Adult↗

PubMed2003

[Thyroglossal duct cysts: a retrospective study].

BACKGROUND: Thyroglossal duct cysts are in second place after goitre as a cause of anterior neck mass in paediatric age. The essentially clinical diagnosis is made on the basis of the observation of an asymptomatic mass, in most cases between the ages of 3 and 5. In this study we re-examined the cases of thyroglossal duct cyst which underwent surgical correction at our Operative Unit in the last 25 years, with particular attention to the factors involved in the recurrences. METHODS: Patients studied numbered 76 with average age at the first operation of 5.3 years; diagnosis was based on clinical and echographic criteria. In 42% of patients one or more episodes of inflammation or suppuration characterised the clinical history. All operations were carried out according to Sistrunk's technique. Follow-up varied from 6 months to 25 years. RESULTS: The percentage of recurrences was 11.8%. The percentage of cysts with inflammation was similar in the group of recurrences and in that of non-recurrences. CONCLUSIONS: In conclusion, in the presence of a radical surgical intervention, the existence of inflammation does not significantly influence the incidence of recurrence. This radicality should be understood both in the sense of depth (exeresis of the hyoid bone) and in the sense of laterality (removal of the lateral ramifications starting from the main residual duct).

Child↗

PubMedDate not supplied

[Papillary carcinoma in an isthmic thyroglossal duct cyst: clinical considerations].

Cancer in a thyroglossal duct cyst is uncommon (incidence: approximately 1%). There are about 250 reported cases in the literature, most of which are papillary cancers or, less frequently, squamous or follicular carcinomas. The preoperative diagnosis of thyroglossal duct cyst carcinoma may be facilitated by an ultrasound neck examination or fine needle aspiration cytology (FNAc). As reported in the literature, however, the diagnosis is often obtained only at histopathological examination. We describe a case of a 43-year-old male patient with a papillary carcinoma in an isthmic thyroglossal duct cyst. Ultrasound of the neck demonstrated a nodular hypo-anechogenic cystic neoformation of the isthmus of the thyroid, while Fnac was not diagnostic. An isthmectomy of the thyroid was initially performed. Frozen examination of the cystic lesion revealed a papillary carcinoma in the thyroglossal duct cyst. A total thyroidectomy with central lymphectomy was therefore performed. Carcinoma in the thyroglossal duct has a low mortality (5-year mortality: < 2%), but a long-term follow-up is mandatory, due to the low, short-and medium-term recurrence rate.

Adult↗

PubMed1995

[Papillary carcinoma on the site of a thyroglossal duct cyst: report of a case].

The thyroglossal tractus cysts are uncommonly the site of malignant tumors. The detection of such located cancer is always histologic. No clinical sign makes thought the malignant degeneration of a thyroglossal tractus cyst. The authors report here one case of papillary carcinoma of thyroïdal origin developed on thyroglossal tractus cyst. At total thyroïdectomy which was carried out three weeks later, a thyroïd papillary carcinoma was found to be present. So, we think that it is interesting to do a literature review about the malignant degeneration of these cysts, based mainly on relationship between this tumor and an eventual lesion of the thyroïd body. The therapeutical management of cancers of cysts is solely surgical and in general the prognosis of these cancers is excellent.

Adult↗

PubMed1996

Concurrent papillary and squamous carcinoma in a thyroglossal duct cyst: a case report.

Carcinomas of thyroglossal duct cysts are rare. Most are papillary carcinomas; only about 5% are squamous cell carcinomas. Only one case of mixed papillary and squamous cell carcinoma of a thyroglossal duct cyst has been reported so far. The authors present a second case, that of a 38-year-old man who was first seen with a midline neck lump. It was diagnosed clinically as a thyroglossal duct cyst and was locally excised. Pathological examination showed both a concurrent papillary carcinoma and a squamous cell carcinoma. Treatment consisted of a near-total thyroidectomy, ablative radioactive iodine and adjuvant external radiation therapy. The authors review the literature and explain the rationale behind their choice of treatment.

Adult↗

PubMed1991

Primary papillary carcinoma of a thyroglossal duct cyst: report of a case and literature review.

Thyroglossal duct cysts are the most common anomaly in thyroid development. They are twice as frequent as branchial cleft abnormalities and, in children, are second only to enlarged cervical lymph nodes as the cause of neck mass. Generally, duct cysts are benign, but 1 per cent of cases may be malignant. From the world literature, 114 cases of malignant thyroglossal cysts were available for review. With the addition of our own case, we discuss 115 instances of duct cysts. The different types of neoplasia described included thyroid papillary carcinoma in 81.7 per cent, mixed papillary-follicular carcinoma in 6.9 per cent, squamous cell carcinoma in 5.2 per cent, follicular and adenocarcinoma in 1.7 per cent each, and malignant struma, epidermoid carcinoma and anaplastic carcinoma in 0.9 per cent each. Of the 115 cases surveyed, 35 thyroid glands were examined microscopically; of these, four (11.4 per cent) contained malignant foci. Whether these are primary malignancies of the thyroglossal duct cysts or metastases is discussed.

Adult↗

PubMed2004

Management of thyroglossal duct cysts in children.

BACKGROUND: The recurrence rate of thyroglossal duct cysts removed by Sistrunk or other procedures is 4% and 50%, respectively. The aim of the present study was to explain the reasons for recurrence and misdiagnosis. METHODS: Twenty-seven children underwent surgery for thyroglossal cysts and fistulas during 1989-2000. Age, sex, length of history, presentation, preoperative investigations, operative findings, histopathology of the lesion and length of excised hyoid bone, postoperative complications and length of follow-up were recorded. Statistical analysis was performed using Fisher's exact test with a significance level of P < 0.05. RESULTS: Twenty-three patients were primary referrals and four were secondary referrals having had previous surgery with misdiagnosis. The recurrence rate after a Sistrunk procedure was similar to the rate indicated in the literature (3.7%); however, no related special features could be identified such as inflammation (n = 12), perforation at surgery (n = 7), presentation with fistula (n = 4) or previous drainage of abscess (n = 5) (P > 0.05). CONCLUSION: Misdiagnosis is the most common cause of inadequate and inappropriate surgery, leading to recurrence of the lesion. The authors recommend a Sistrunk procedure for all cases of suspected thyroglossal duct cysts.

Adolescent↗