ABSTRACT
Thyroglossal duct cyst is a congenital malformation occurring due to incomplete closure of the thyroglossal duct. The infrequency with which it is encountered in thyroid makes it a formidable diagnostic challenge. Authors report this case because of the rarity of intrathyroid location of thyroglossal cyst.
ABSTRACT
A thyroglossal duct cyst (TGDC) is the most common congenital anomaly of the neck. However, carcinoma arising from TGDC is extremely rare. We report 2 cases of TGDC carcinoma. In the first case, a 21-year-old male patient complained of an anterior cervical mass; computed tomography (CT) and sonography revealed cystic mass that was suspected to be a TGDC. Sistrunk operation was performed. Papillary carcinoma was confirmed in pathologic examination. Additionally, he underwent total thyroidectomy and central neck dissection. After radioactive iodine ablation (RAI) was performed. In the second case, a 28-year-old male patient visited our out-patient department complaining of submental mass. He had already been diagnosed TGDC carcinoma 13 years ago and had undergone Sistrunk operation and total thyroidectomy. Malignancy was confirmed using fine-needle aspiration; thus, lateral neck dissection was performed and following this, he underwent RAI. Till date, no evidence of recurrence has been observed in these patients.
Subject(s)
Adult , Humans , Male , Young Adult , Biopsy, Fine-Needle , Carcinoma, Papillary , Iodine , Neck , Neck Dissection , Outpatients , Recurrence , Thyroglossal Cyst , Thyroid Gland , ThyroidectomyABSTRACT
Thyroglossal duct cyst is the most common upper neck midline lesion in children. Approximately 1% of thyroglossal duct cyst undergoes malignant transformation. Calcification which is a marker of malignancy almost always points out to papillary thyroid carcinoma. Benign case of calcified thyroglossal cyst maybe undiagnosed or under reported. We report a case of a 5 year old girl with a benign calcified thyroglossal duct cyst, a fourth case in world literature. Here the differences between a benign and malignant thyroglossal duct cyst are discussed.
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Objective To investigate the clinical characteristics and surgical methods of children with thyroglossal duct cyst (TDC).Methods A retrospective analysis was made on the clinical data and imaging characteristics from 98 cases of children with primary thyroglossal duct cyst and 40 cases of children with recurrent thyroglossal duct cyst during the time 2012 to 2015 in Kunming children's Hospital's Otolaryngology Head and Neck Department.For new-onset cases,the classic Sistrunk operation method was chosen;for postoperative recurrence cases,the enlarged Sistrunk operation method was chosen.Results Thyroglossal duct cyst CT appeared single cystic lesion and polycystic lesions;the single cystic lesion was located under the level of the hyoid bone and on the level of the hyoid bone;polycystic lesions were located in the upper and lower hyoid bone,and highly related to hyoid and thyroid;B ultrasonic results showed low echo or heterogeneous echo,no substance,with posterior echo enhancement.Sistrunk operation and the enlarged Sistrunk operation treatment efficacy was positive for new-onset cases and postoperative recurrence patients.No recurrence was found in 2 years of follow-up.Conclusions The pathogenic and anatomical characteristics of thyroglossal duct cyst should be fully understood.The hyoid bone and the surrounding area of the glossal blind aperture in the base of the tongue are the focal point of surgical operation;ring ligation is the key after resection of the diseased tissue.
ABSTRACT
Antecedentes: el carcinoma diferenciado de tiroides en quiste tirogloso (CaQT) es una entidad rara. La incidencia de CaQT es de 1 a 2%. Usualmente su forma de presentación clínica es indistinguible de una lesión benigna y el diagnóstico definitivo es postquirúrgico. No hay en la actualidad un consenso sobre la indicación de tiroidectomía total, radioablación con iodo y/o terapia supresiva con levotiroxina luego de ser extirpado quirúrgicamente...
Introduction: the development of well -differentiated thyroid carcinoma in thyroglossal duct cysts (TGDCa) is uncommon. The incidence of TGDCa lies within 1 to 2%. Usually the clinical appearance is indistinguishable from a benign thyroglossal duct cyst. The definitive diagnosis is post-operative. After the surgery of choice, the other alternative treatments such as thyroidectomy, radioiodine and L-T4 therapy are controversial...
Antecedentes: o carcinoma diferenciado de tireoide em cisto tirogloso (CaQT) é uma entidade rara. A incidência de CaQT é de 1 a 2 por cento. Em geral, a sua forma de apresentação clínica é indistinguível de uma lesão benigna e o diagnóstico definitivo é pós-cirúrgico. Não existe atualmente um consenso sobre a indicação de tiroidectomia total, radioablação com iodo e/ou terapia supressiva com levotiroxina após ser extirpado cirurgicamente...
Subject(s)
Male , Female , Humans , Adolescent , Adult , Child , Young Adult , Middle Aged , Carcinoma, Papillary/diagnosis , Carcinoma, Papillary/therapy , Thyroglossal Cyst/diagnosis , Thyroglossal Cyst/therapy , Algorithms , ConsensusABSTRACT
Thyroglossal duct cyst (TDC) is a developmental anomaly that usually appears in early childhood. The common presentation is midline swelling of the neck, which moves with both tongue protrusion and deglutition. Diagnosis is usually clinical and radiological. Fine needle aspiration cytology (FNAC) can be used as a tool for the exclusion of malignancy in adult patients. In some cases thyroid scan is done to rule out the presence or absence of the normal thyroid gland. A complete work-up is mandatory before cyst removal given that it contains only thyroid tissue. We report the case of a 32-year-old woman with only thyroid tissue in thyroglossal duct cyst.
Subject(s)
Thyroglossal Cyst , Thyroid Gland , UltrasonographyABSTRACT
Objective To analyse the clinical characteristics of infants in two months old of lingual thyroglossal duct cysts (LTGDC) and raise the levels of diagnosis and treatment.Methods A comparative analysis was made between the clinical data of 23 cases in two months old of LTGDC and those of 20 cases in one to seven years old of cervical thyroglossal duct cysts (TGDC) (control group).Results The clinical manifestation appeared obviously differences between LTGDC and TGDC.The main performance of LTGDC was laryngeal stridor,and 74％ of them went to emergency department because of dyspnea.They would be misdiagnosed as congenital laryngomalacia or laryngomalacia with pneumonia.The lesion located in the posterosuperior of lingual bone and behind the root of tongue,which was easy to lead to throat obstruction because it extruded laryngeal cavity.Electronic laryngoscopy was the first choice,it helped to identify laryngomalacia,epiglottis cyst and hemangioma.Laryngeal CT or MRI was very important to diagnose LTGDC which was quasi-circular low density shadow with clear boundary,or not extruded to laryngeal cavity,or show lesion range and surrounding structures avoiding misdiagnosis.As treatment depended surgery which was selfretaining laryngoscope,it was minimally invasive and without scar.Cervical anterior mass in the midline was the first symptoms in all 20 cases of TGDC.The neck ultrasound examination was the first selection,and the lesion showed fluid dark space with clear boundary,it should take the neck percutaneous surgical operation.Conclusion The clinical manifestation of infants in two months old of LTGDC appears obviously different from TGDC.LTGDC is a common cause of laryngeal stridor with breathing difficulties.It will be misdiagnosed as congenital laryngomalacia and lead to asphyxia or death easily.
ABSTRACT
Thyroglossal duct carcinoma is uncommon, occurring in approximately 1% of all thyroglossal duct remnants. This rare neoplasm is characterized by relatively nonaggressive behavior with infrequent lymph nodal spread. Another rare neoplasm of the head and neck region is a carotid body tumor. A 78-year-old woman with a 3-year history of midline and bilateral neck masses was referred to us. Fine needle aspiration biopsies and a computed tomography scan suggested the diagnosis of thyroglossal duct carcinoma with cervical lymph node metastasis. Interestingly, the left-side neck mass was found to be splaying the carotid bifurcation, on computed tomography imaging. Carotid arteriography demonstrated a highly vascular mass in the bifurcation of the carotid artery that was compressing the internal and external carotid arteries. To our knowledge, this is the first reported instance of a thyroglossal duct carcinoma with neck metastasis accompanied by a carotid body tumor. In addition, the carotid body tumor in this case mimicked neck metastasis from the thyroglossal duct carcinoma.
Subject(s)
Aged , Female , Humans , Angiography , Biopsy , Biopsy, Fine-Needle , Carotid Arteries , Carotid Artery, External , Carotid Body Tumor , Carotid Body , Diagnosis , Head , Lymph Nodes , Lymphatic Metastasis , Neck , Neoplasm Metastasis , Thyroglossal CystABSTRACT
Thyroglossal duct cyst (TGDC) carcinoma generally shows a favorable prognosis. If metastasis is present latently, it may not threaten the patient's life immediately. It has been shown, however, that larger than 1 cm papillary carcinoma (PC), level VI metastasis to the lymph node (LN), which is the nearest to the thyroid, independently predicts a worse prognosis. In the case presented herein, a 61-year-old female patient was diagnosed with an about 3 cm PC in the TGDC, particularly the columnar variant subtype, one of the aggressive variants. She had occult papillary thyroid microcarcinoma, but no LN metastasis. Even though she underwent the Sistrunk procedure and total thyroidectomy with central compartment neck dissection followed by high-dose radioactive iodine remnant ablation, however, the cancer cells spread to level IV neck LN, and finally to the lung. Therefore, when a patient is diagnosed with an aggressive histologic variant of PC in the TGDC, even without LN metastasis, the invasive surgical approach and close postoperative surveillance are necessary, with consideration of the risk of disease progression. Therefore, if it is possible to stratify the risk for patients, higher-risk patients can be offered a more invasive therapeutic approach.
Subject(s)
Female , Humans , Middle Aged , Carcinoma, Papillary , Disease Management , Disease Progression , Iodine , Lung , Lymph Nodes , Neck , Neck Dissection , Neoplasm Metastasis , Prognosis , Thyroglossal Cyst , Thyroid Gland , ThyroidectomyABSTRACT
PURPOSE: Thyroglossal duct cyst (TGDC) is known to be the most common midline neck mass in children, but the adult population still has this abnormality. The most common symptom of TGDC is a simple neck mass, and differential diagnosis among other abnormalities is important. The aim of this study is to perform a retrospective view of TGDC in order to describe any differences in clinical features, diagnostic tools, treatment, and outcomes in children and adults who underwent surgery in a single institution, and to determine its clinical implications. METHODS: We performed a retrospective chart review on 75 pathologically diagnosed TGDC patients from 1995 to 2013 who were divided into two groups: children (< or =18 years) and adults. Comparison analysis was performed for age, sex, site and location of cyst, size, diagnostic tool, surgical method, and postoperative outcome. RESULTS: Our study showed frequent occurrence of TGDC in adults. There was no significant sex, site, or location difference in the occurrence of TGDC in children and adults, however, the size of cyst in adults was larger than that in children (mean, 2.80 cm vs 2.15 cm) (P<0.001). Four patients (5.3%) had postoperative recurrence of TGDC, and Sistrunk operation showed lower recurrence rate than excision (3.1% vs 18.2%) (P<0.040). Two malignancy cases were identified postoperatively in adults. CONCLUSION: Particularly in adults, the possibility of carcinoma would make it important to perform fine-needle aspiration for differential diagnosis. Sistrunk procedure will remain the treatment of choice for most TGDC patients considering recurrence risk.
Subject(s)
Adult , Child , Humans , Biopsy, Fine-Needle , Diagnosis, Differential , Neck , Recurrence , Retrospective Studies , Thyroglossal CystABSTRACT
El quiste del conducto tirogloso es una de las anomalías del desarrollo que se presenta más frecuentemente en el cuello. La presencia en este de carcinoma aislado o concomitante con cáncer en tiroides, es muy infrecuente. Se expone aquí el caso de una paciente joven que se presentó con esta entidad. Se describe su presentación y manejo. Actualmente sigue su control en el Servicio de Endocrinología del Hospital San Vicente de Paúl, Heredia, Costa Rica...
Subject(s)
Humans , Adult , Female , Thyroglossal CystABSTRACT
Background: to report a rare case of papillary carcinoma in thyroglossal duct cyst and discuss its management. Material and Method: a 72 year-old man was clinically diagnosed to have a big thyroglossal duct cyst. Sistrunk's procedure followed by total thyroidectomy on the evidence of papillary cancer in thyroglossal duct cyst. Results: histopathologic examination revealed a papillary carcinoma in the thyroglossal duct cyst and normallity in the thyroid gland. The patient remained free of disease on follow-up. Conclusion: most cancers arising in thyroglossal duct cyst are of low risk, and Sistrunk's procedure with a total thyroidectomy is an adequate treatment for such cancers.
Objetivo: reportar un caso raro de carcinoma papilar en un quiste tirogloso y discutir su manejo. Paciente y Método: un hombre de 72 años a quien se realizó un diagnóstico clínico de un quiste tirogloso, fue llevado a una cirugía de Sistrunk's y luego una tiroidectomía total ante la evidencia de cáncer papilar en el quiste tirogloso. Resultados: el examen histopatológico reveló un carcinoma papilar de tiroides en el quiste tirogloso y la glándula tiroides fue normal, el paciente permaneció libre de enfermedad en su seguimiento. Conclusiones: la mayoría de los cánceres que surgen en quiste del conducto tirogloso son de bajo riesgo, y el procedimiento Sistrunk's con una tiroidectomía total es un tratamiento adecuado para este tipo de cáncer.
Subject(s)
Humans , Male , Aged , Carcinoma, Papillary/surgery , Thyroid Neoplasms/surgery , Thyroglossal Cyst/surgery , ThyroidectomyABSTRACT
Obstructive sleep apnea (OSA) is a common disorder. It usually results from the structural compromise of the upper airway. In patients with OSA, the obstruction predominantly occurs along the pharyngeal airway, and also a variety of tumors have been reported to cause such a condition. We present here the case of a thyroglossal duct cyst causing OSA in adult. This case demonstrates that thyroglossal duct cyst or some kind of mass lesions in the airway lesions should be considered in the differential diagnosis of OSA patients.
Subject(s)
Adult , Humans , Diagnosis, Differential , Sleep Apnea Syndromes , Sleep Apnea, Obstructive , Thyroglossal Cyst , Sleep Wake DisordersABSTRACT
Thyroglossal duct cyst (TGDC) and lingual thyroid (LT) are two relatively common anomalies of thyroid gland development. Each may occur without the orthotopic thyroid gland, although the co-existence of these three anomalies is very rare. The thyroidal function may be abnormal in both anomalies, and careful evaluation of thyroid function is essential for the management of these lesions. A 71-year-old woman was admitted to our department for removal of midline neck mass. She underwent the classical Sistrunk's operation, but after the surgery, her hypothyroidism became aggravated. We report, along with a literature review, an extremely rare case of co-existence of TGDC and LT in the absence of orthotopic thyroid gland.
Subject(s)
Aged , Female , Humans , Hypothyroidism , Lingual Thyroid , Neck , Thyroglossal Cyst , Thyroid GlandABSTRACT
A Thyroglossal Duct Cyst (TGDC) is the most common cause of midline neck masses and is characterized in sonography as an anechoic or hypoechoic well-circumscribed cyst with posterior enhancement. TGDCs mostly occur in children and are easy to spot in them, but the sonographic appearance of TGDCs in adults is variable, ranging from a typical anechoic to a pseudosolid appearance. The presence of a solid component should alert the radiologist to the possibility of a cancer arising from the thyroglossal duct. We report here on our experience with a 58-year-old woman who had a complicated TGDC with a suspicious sonographic appearance of malignancy.
Subject(s)
Adult , Child , Female , Humans , Middle Aged , Neck , Thyroglossal CystABSTRACT
Thyroglossal duct cysts (TGDC) are the most common congenital cervical abnormality, resulting from the remnant epithelial tissue of the thyroglossal duct, occuring in up to 70% of all congenital neck abnormalities. TGDC can be found anywhere in the midline between the foramen cecum and the thyroid gland, but are most frequently found below the level of the hyoid bone (65%), and may occur above the hyoid (20%) or at the level of hyoid (15%). Although they are commonly found near the hyoid bone, they can also be located on the base of the tongue (2%) or lower in the neck (10%). But TGDC found on the posterior surface of the thyroid, the location of parathyroid, is rare. Here, we report a case of a 43-year-old man with TGDC in the posterior of the right thyroid lobe, which was misdiagnosed as a parathyroid adenoma.
Subject(s)
Adult , Humans , Cecum , Hyoid Bone , Neck , Parathyroid Neoplasms , Thyroglossal Cyst , Thyroid Gland , TongueABSTRACT
Objective To analyze clinical features and surgical treatment of thyroglossal duct cyst (TDC) in adult patients.Methods Clinical data of 36 adult patients with TDC were analyzed retrospectively.Results All the 36 patients received surgical resection of Sistrunk's procedure.One case suffered wound infection after the operation.Two cases recurred(recurrence rate:5.6％)but cured after the 2nd operation and showed no sign of recurrence during the follow up of 18 and 26 months respectively.No other complications were reported.Conclusions Etiological factors,pathological and anatomical features need to be analyzed.Surgical treatment should focus on hyoid bone and the upper area.The recurrence rate depends on total resection of cyst.
ABSTRACT
Thyroglossal duct cysts (TGDC) are the most common type of congenital developmental anomaly encountered in the anterior midline of the neck in childhood. The aim of the study was to evaluate the clinical characteristics of TGDC and identify any factors that could be related to recurrence after surgery. This study consisted of a retrospective chart review of 45 patients treated at Kyungpook National University Hospital for TGDC between 1990 and 2008. All records were reviewed for age and sex, length of history, presentation, diagnostic methods, sizes and locations of cyst, surgical management, histopathology of the lesion and recurrences. The statistical analysis of risk factors for recurrence was made using the Fisher's exact test with a significance level of p < 0.05. The male to female ratio was 2.2:1 with a male preponderance. The mean age at operation was 5 years and 2 months (4 months - 17 years). The most common presenting symptom was a nontender cervical mass (78%). Most TGDC were found in the midline position. Twenty four were infrahyoid, 17 were hyoid, and 4 were suprahyoid level. Forty one (91%) patients received the Sistrunk operation, and 4(9%) patients received cyst excision. Postoperative a seroma developed in six patients in the early postoperative days. There were a total of 3(6.6%) recurrences, 2 in patients who had excision only and in one patient who had the Sistrunk operation. Univariate analysis for risk factors with recurrence showed that there was no statistical relationship between the presence of preoperative infection and the development of recurrence. The removal of hyoid bone along with TGDC was a statistically significant risk factor for recurrent disease. This study suggests that the Sistrunk operation is the treatment of choice for TGDC in order to reduce recurrence.
Subject(s)
Child , Female , Humans , Male , Hyoid Bone , Neck , Recurrence , Retrospective Studies , Risk Factors , Seroma , Thyroglossal CystABSTRACT
This is a case report on papillary thyroglossal duct cyst (TGDC) carcinoma along with synchronous occult papillary thyroid microcarcinoma. A 46-year-old woman visited our hospital because she had an anterior midline neck mass below her hyoid bone. Preoperative ultrasound-guided fine-needle aspiration cytology revealed signs of papillary TGDC carcinoma. We performed a Sistrunk operation and a total thyroidectomy. Histopathological examination of the specimen revealed papillary carcinoma arising in the TGDC and papillary microcarcinoma of the thyroid gland without extrathyroidal extension. Surgeons should be aware of TGDC carcinoma during surgical planning and postoperative treatment and should differentiate this carcinoma from an anterior midline neck mass.
ABSTRACT
Failed or difficult tracheal intubation remains an important cause of mortality and morbidity during anesthesia, especially in infants with anatomical or pathological abnormalities of the airway.We report on a 4.1 kg, 85-day-male infant with a thyroglossal duct cyst at the tongue base who could not be conventionally ventilated and intubated in the supine position.The infant was intubated with a 3-mm endotracheal tube through the laryngeal mask airway (LMA) with guidance of a fiberoptic bronchoscope (FOB).However, the pilot balloon did not pass through the 1.5-mm LMA conduit.After cutting the pilot balloon, we removed the LMA and inserted a central venous catheter guide-wire through the endotracheal tube to increase the endotracheal tube to 3.5 mm.This maneuver allowed us to secure the airway without further problems.