Clinical analysis of gasless transoral vestibular robotic resection of thyroglossal duct cysts / 临床耳鼻咽喉头颈外科杂志

Objective:This study aimed to explore the safety and feasibility of gasless transoral vestibular robotic resection of thyroglossal duct cysts. Methods:The clinical data of patients who underwent gasless transoral vestibular robotic resection of thyroglossal duct cysts at the Department of otolaryngology, Sun Yat-sen Memorial Hospital, Sun yat-sen university from September 2020 to May 2022 were analyzed. The operative time, blood loss, postoperative complications, postoperative pain score, postoperative aesthetic score, and recurrence were prospectively evaluated. Results:All patients completed the operation successfully and no case conversed to an open operation. The operation time was 104.00（95.00, 131.25） minutes, and the surgical blood loss was 15.00（10.00, 16.25） mL. The drainage volume was（59.71±9.20） mL. Postoperative pathology was consistent with thyroglossal duct cysts. There was no local reswelling, subcutaneous hematoma, emphysema, skin flap necrosis, infection and other complications. The postoperative hospital stay was 3.00（2.00, 3.00） days. Six patients had mild sensory abnormalities of the lower lip 3 months after surgery, and all patients were satisfied with the cosmetic outcomes. No recurrence was found during the 5-26 months follow-up. Conclusion:gasless transoral vestibular robotic resection of thyroglossal duct cysts is safe and feasible, with hidden postoperative scars and good cosmetic outcomes. It can provide a new choice for patients with thyroglossal duct cysts.

Cáncer Papilar en Quiste Tirogloso. Caso Clínico y Revisión de la literatura / Papillary Cancer in Tirogloso Cyst. Case report and review of literature

INTRODUCCIÓN: Los quistes tiroglosos son las lesiones más comunes de la línea media cervical y se ha descrito el carcinoma papilar de tiroides en el 1%. Debido a su baja incidencia no existe un consenso acerca del tratamiento óptimo. Caso clínico: Paciente mujer de 34 años de edad consulta por aumento de volumen cervical doloroso y se evidencia nódulo doloroso en región cervical media. Ecografía de tiroides visualiza una lesión quística compleja. Se completa el estudio con tomografía computada del cuello con contraste que evidencia quiste del conducto tirogloso con compromiso inflamatorio-infeccioso, por lo que se decide cirugía. Biopsia evidencia cáncer papilar de 0.25 cm en quiste del conducto tirogloso, con bordes quirúrgicos negativos. Por bajo riesgo se decide control imagenológico estricto. DISCUSIÓN: Los quistes del conducto tirogloso comprenden las lesiones cervicales congénitas más frecuentes. Se presentan como masas indolentes y asintomáticas. El diagnóstico es confirmado mediante ecografía y la tomografía es utilizada para ampliar el estudio. La aparición de cáncer tiroideo en estos quistes es poco común, y generalmente son indistinguibles de las lesiones benignas en el preoperatorio. En relación al manejo del cáncer papilar en quiste del conducto tirogloso no existe un consenso de su tratamiento óptimo. Para los casos de bajo riesgo se sugiere control anual con TSH y ecografía tiroidea. Para aquellos pacientes de alto riesgo se sugiere tiroidectomía total y ablación de los restos tiroides con yodo radioactivo, con control anual con niveles de tiroglobulina. El pronóstico es excelente, con tasas de remisión que superan el 95%. CONCLUSIONES: Los carcinomas en quistes de conducto tirogloso son poco comunes y en la mayoría de los casos son lesiones diagnosticadas de manera incidental después de la resección quirúrgica. Para definir necesidad de tiroidectomía, debe realizarse estudio individualizado por un equipo multidisciplinario con amplia experiencia.

INTRODUCTION: Thyroglossal cysts are the most common affection of the cervical midline. Papillary carcinoma has been described in 1% of this cysts. Due to its low incidence a consensus on the optimal treatment does not exist. Clinical case: A 34 year old female with no relevant past medical history, presented with a painful cervical mass of many weeks of appearance. The thyroid ecography showed a complex cystic lesion and the cervical computed tomography with contrast evidenced a cyst of the thyroglossal duct with inflammatory and infectious findings. Surgery with no incidents was performed. Biopsy reported a 0.25 cm papillary cancer in the thyroglossal duct cyst, with negativa surgical margins. Strict follow up with imaging studies was decided. DISCUSSION: the thyroglossal duct cyst are the most common congenital cervical affections. Classically, they present as indolente, asyntomatic masses on the cervical midline. The diagnosis is confirmed with ecography and computed tomography is used to extent evaluation. Thyroid cancer in thyroglossal duct cyst is uncommon and generally indistinguishable from benign lesions in the preoperative phase. A consensus regarding the optimal management of this patients does not exist. For low risk cases, an anual control with THS and thyroid ecography is suggested. For patients with high risk a Sistrunk with total thyroidectomy and radioactive ablation of thyroids remnants is recommend. Follow up with anual thyroglubin levels should be performed. The prognostic is excellent, with more than 95% remission rates. CONCLUSSIONS: Thyroglossal duct cyst carcinomas are rare. In most cases, diagnosis is made incidentally after surgical resection. To decide wheter thyroidectomy is necessary each case should be analyzed individually by a multidisciplinary team with vast experience.

Papillary Thyroid Carcinoma within Thyroglossal Duct Cyst: Case Series and Literature Review

Abstract Introduction Thyroglossal duct cyst (TGDC) is themost common congenital anomaly of the neck, and approximately 7% of all the adult population presents it. Ectopic thyroid tissue is found in the thyroglossal duct cyst wall in up to 65% of cases. This thyroid tissue has the potential to develop some type ofmalignancy, themost common of which is the papillary carcinoma of the thyroid. There are just over 270 cases of thyroglossal duct cyst malignancy reported in the literature. Objectives We aimed to study our population of patients in order to identify cases with thyroglossal duct cyst malignancy. Methods A retrospective chart review was conducted in the section of otolaryngology/ head and neck surgery at a hospital in Karachi, Pakistan, from January of 2004 to December of 2014 on patients with the diagnosis of thyroglossal duct cyst. Results Fifty-eight patients were diagnosed with TGDC, two of whom also presented with thyroglossal duct cyst carcinoma. Both patients revealed papillary thyroid carcinoma on histopathology. Case 1 had an open biopsy before undergoing definitive surgery. Both patients underwent subsequent total thyroidectomy after Sistrunk procedure, and case 2 had selective neck dissection revealing lymph node metastasis. Conclusion Thyroglossal duct cyst carcinoma is a rare finding that comes as a surprise to both the patient and the surgeon. We report 2 out of 58 cases diagnosed with thyroglossal duct cyst carcinoma.

Experiencia en el manejo de la patología del conducto tirogloso: serie de casos / Experience in thyroglossal duct pathology: clinical case series

La patología del conducto tirogloso constituye la segunda anomalía cervical benigna más frecuente en la infancia. El diagnóstico es principalmente clínico. Sistrunk fue quien describió la técnica quirúrgica considerada de elección para el tratamiento definitivo de esta patología. Estudio descriptivo retrospectivo. Entre junio de 2008 y agosto de 2015 se realizaron 54 procedimientos en 45 pacientes (39 casos primarios). La mediana de edad fue de 4,7 años; 14/39 pacientes (31,1%) presentaron infección preoperatoria. Todos los pacientes fueron evaluados inicialmente por ecografía. Todos fueron tratados mediante la técnica de Sistrunk. La recidiva global fue de 17,8%.

The thyroglossal duct cyst pathology represents the second cause of bening cervical anomalies in childhood. Diagnosis is mainly clinical. Sistrunk (1920) proposed a surgical technique that is still considered the gold standard for definitive treatment of this condition. A retrospective study was made including patients who underwent surgery for thyroglossal duct cyst pathology in our department between June 2008 and August 2015. In this period, we performed 54 procedures in 45 patients (39 primary cases). Median age was 4.7 years; 14/39 patients (31.1%) had pre-operative infection. All patients were studied with neck ultrasound. A Sistrunk's procedure was performed in all cases. The global recurrence rate was 17.8% (8/45).

Carcinoma papilar de quiste de conducto tirogloso sincrónico con carcinoma papilar de tiroides / Synchronous papillary carcinoma of thyroglossal duct cyst and papillary thyroid carcinoma

Presentamos el caso de un paciente diagnosticado de quiste de conducto tirogloso y un nódulo tiroideo ístmico en el que se evidenciaron focos de carcinoma papilar intraquístico concomitantes con carcinoma papilar en el nódulo tiroideo. La indicación terapéutica en estos casos es controvertida, y dependerá en la mayoría de los casos del estudio microscópico de la muestra. En nuestro caso se realizó en un primer tiempo la intervención de Sistrunk asociada a una istmectomía y tras conocer el resultado de ambas muestras se decidió realizar tiroidectomía total.

We report the case of a patient with a thyroglossal duct cyst and a nodule at the thyroid isthmus which showed intracystic papillary carcinoma foci concomitant with papillary carcinoma in the thyroid nodule. The therapeutic indication in these cases is controversial. In our case it was done in a first intervention a Sistrunk technique associated to an isthmectomy and after knowing the results of both samples was decided to perform a total thyroidectomy.

Carcinoma papilar en quiste tirogloso: reporte de 4 casos y revisión de la literatura / Papillary carcinoma in a thyroglossal duct cyst: report of 4 cases and review of literature

Introducción: El quiste tirogloso es una de las masas cervicales más frecuentes. En 1 por ciento puede desarrollar un cáncer, siendo el más frecuente el carcinoma papilar tiroideo. Objetivo: Describir la presentación clínica, el diagnóstico, el manejo y la evolución de los casos de carcinoma papilar tiroideo en quiste tirogloso. Material y método: Se revisaron los archivos del Departamento de Patología de la Universidad de Concepción desde 2000 a 2010 analizando las fichas clínicas y el informe de la biopsia. Resultados: Se encontraron 4 casos de carcinoma papilar en quiste tirogloso, todos de sexo femenino con un promedio de edad de 42 años. Todos fueron sometidos a la operación de Sistrunk. Dos casos fueron sometidos a tiroidectomía total y terapia con radioyodo complementaria. Sólo un paciente presentaba un cáncer sincrónico en la tiroides. El seguimiento promedio fue de 4,7 años y no se presentaron recidivas. Conclusiones: Se encontraron 4 casos, se analiza su presentación, diagnóstico, tratamiento y evolución.

Introduction: Thyroglossal duct cyst is one the most frequent cervical masses. Cancer may develop from 1 percent among them, thyroid papillary carcinoma being the most frequent. Aim: To describe the clinical presentation, diagnosis, management and evolution of thyroid papillary carcinoma cases in thyroglossal duct cyst. Material and method: A review was made of the files from the department of pathology of the Universidad de Concepción, since 2000 to 2010, analyzing clinical records and biopsy reports. Results: Four cases of papillary carcinoma in a thyroglossal duct cyst were found, all female with a mean of age of 42 years. All of them underwent Sistrunk procedure. Two cases underwent total thyroidectomy and complementary radioiodine therapy. Only one patient presented synchronic thyroideal cancer. The mean time of follow up consisted of 4,7 years, with no reported recurrence. Conclusions: We found 4 cases, his presentation, diagnosis, treatment and evolution was analyzed.

Thyroglossal sinus; demographic and anatomical features of thyroglossal sinus

To assess demographic and anatomical features of thyroglossal sinus. Descriptive. ENT department Allied Hospital Faisalabad. From Jan 2005 to June 2010. The patients were admitted through ENT out patient department. The data was collected on the basis of history, physical examination, investigations, management and follow up. Total 60 patients 35 males [58%] and 25 females [42%]. The majority of patients were from second decade of life 28 [47%]. The most common location of thyroglossal sinus was thyrohyoid 55 [92%]. The etiology of of thyroglossal sinus in majority of cases was iatrogenic 50 [83%]. The common clinical presentation was discharging sinus in the neck 60 [100%]. The histological diagnosis in all the cases was benign 60 [100%].All the patients were managed by Sistrunks operation 60 [100%].The recurrence was seen in 4 cases [07%]. The incidence of thyroid carcinoma was 00%. Overall success rate was 93%. The prevalence of thyroglossal sinus is quite considerable. The majority of cases are iatrogenic which means that more awareness is required about diagnosis and proper management of thyroglossal cyst. The incision and drainage of thyroglossal cyst should be avoided to prevent the development of thyroglossal sinus. In all the cases the specimen should be sent for histopathology to rule out the thyroid carcinoma

Double thyroglossal duct cyst derived from a single tract: a rare presentation

Thyroglossal duct cysts are one of the most common congenital pathologic findings in children's cervical area. This type of cyst can be located anywhere between the base of the tongue and the sternal manubrium. We report the case of a patient with a double thyroglossal cyst, located inferior to the hyoid bone. The 2 cysts were connected by a common permeable tract, which confirms that an evolution failure of the embryonic remnants of the thyroglossal duct has been responsible for the development of such a cyst. Our case is the second case of double thyroglossal duct cysts and the first of double cysts located in the neck outside the thyroid gland

Thyroglossal duct cyst: a descriptive study of 41 cases

To describe the clinical presentations and site distribution of the thyroglossal duct cyst. This descriptive study was conducted at the Department of ENT District Headquarter Hospital Timergara from May 2001 to December 2007. The various presentations and management options were observed and documented using a semi structured proforma. Complications or recurrences, if any, were noted. A total of 41 cases of thyroglossal duct cyst with a mean age of 16. 7 +/- 17.49 years were included in the study. There were nineteen female and twenty two male patients. There were 9 recurrent and 32 cases. Forty patients presented with midline cystic swelling that moved with protrusion of tongue, seven with sore throat, 4 with dysphagia and 3 with globus. Forty [97.57] cases were central [9 [21.97%] suprahyoid and 31 [75.60%] infrahyoid] and 01 [2.43%] presented with cystic swelling on left side of the. neck All the cases were subjected to sistrunk operation. The most common presentation of thyroglossal duct cyst is a midline cystic swelling that moves with tongue protrusion. Thyroglossal duct cyst is present centrally in most of the cases

Carcinoma papilar en quiste del conducto tirogloso: reporte de dos casos / Papillary carcinoma in a thyroglossal duct cyst: report of two cases

Thyroglossal duct cyst is the most common congenital anomaly of thyroid gland development. However, papillary carcinoma is described only in 1-2 percent of cases and the clinical appearance is indistinguishable from a benign thyroglossal duct cyst. We report two females aged 15 and 27years consulting for a cervical mass. In both, a solid cystic lesion was found and excised using the Sistrunk procedure. The biopsy disclosed a papillary carcinoma in both. The postoperative evolution of both patients was uneventful.

Carcinoma papilífero em cisto do ducto tireoglosso: a tireoidectomia é necessária? / Papillary carcinoma of thyroglossal duct cyst: is thyroidectmy necessary?

Introdução: o cisto do ducto tireoglosso (CDT) é a doença congênita mais freqüente na região cervical. A presença de neoplasia maligna associada a esse cisto é pouco comum e de difícil diagnóstico pré-operatório. Objetivo: apresentar a experiência com carcinoma papilífero em CDT. Pacientes e Método: foram revistos 35 pacientes consecutivos submetidos à ressecção de CDT e estudados três cssos de carcinoma papilífero dentro do cisto, com análise do tratamento dos mesmos. Resultados: a incidência de carcinoma papilífero foi de 8,5% dos cistos nessa série, sendo duas mulheres e um homem e idade média de 27,3 anos (variação de 25 a 32 anos). Dois pacientes tiveram diagnóstico após cirurgia de Sistrunk e um apresentava biópsia aspirativa por agulha fina pré-operatória sugestiva de neoplasia. Todos os casos foram conduzidos com tireoidectomia total, um deles pela técnica vídeo-assistida, com pesquisa de corpo inteiro com I131 após a cirurgia. Em um paciente, foi encontrada neoplasia prim[aria na tireóide. Conclusão: o carcinoma papilífero em CDT é pouco freqüente. Embora o tratamento seja controverso, nosso ponto de vista é que a tireoidectomia total deva ser indicada, complementando a ressecção do cisto devido à possibilidade de tratar-se de tumor metástico e para facilitar o seguimento posterior. A técnica vídeo-assistida pode ser utilizada para realizar a tireoidectomia total por tratar-se, em geral, de glândulas de tamanho normal

Introduction: the Thyroglossaal duct cyst(TDC) is the most common congenital disease of the cervical region. The presence of associated malignant neoplasm in the cyst is uncommon and is difficult to perform the preoperative diagnosis. Objective: to present our experience with papillary carcinoma in the TDC. Patients and Methods: we reviewed 35 consecutive patients submited to TDC resection with three cases of papillary carcinoma in the cyst and analyzed the treatment. Results: the incidence in this serires was 8.5% of papillary carcinoma in the cysts, with two women and one man, whose mean age was 27.3 years (range, 25 to 32). Two patients were diagnosed after the Sistrunk procedure and one had preoperative fine needle aspiration biopsy suggestive of neoplasm. All patients underwnt complementary total thyrodectomy, one of them underthe videoassisted technique, and total body scintigraphy. In one patient, papillary carcinoma was found in the thyroid gland. Conclusion: the papillary carcinoma in TDC is an uncommon entity. The treatment is controversal, but in our pont of view the total thyroidectomy is indicated as a complement to the cyst resection because it can be metastatic, and to facilitate the follow-up. The videoassisted technique may be used to perform the total thyroidectomy because the glands have commonly normal size

Rare site of papillary carcinoma

Papillary carcinoma of the thyroglossal cyst is a rare disease found in a 21 year-old female patient. Histopathological examination of a completely excised thyroglossal cyst established the diagnosis. Clinically, no differentiation between a benign cyst and malignancy could be made. Neck ultrasonography demonstrates a solid-cystic mass at the midline of the neck and may give the possibility of malignant changes in a thyroglossal cyst and may help in the preoperative diagnosis. Complete excision of the cyst with its tract and a central portion of the hyoid bone is usually sufficient. Long term follow up of the patient is recommended

Thyroglossal duct remnant: seven years analysis.

To analyze the clinico-pathological findings and surgical outcome in a patient population that underwent surgical procedures for the excision of the thyroglossal duct remnant (TGDR) i.e., cyst or sinus. A retrospective descriptive study was performed to include all patients of thyroglossal duct remnant who underwent the surgical procedures at National Academy of Medical Sciences, Nepal form April, 1998 to April, 2005 A.D. Age, sex, position of the thyroglossal duct remnant, histopathology of the lesion, type of surgery and its outcome with particular emphasis on recurrence were noted. All data were obtained from the patients' admission charts. Thirty clinically diagnosed thyroglossal duct remnant were enrolled in this study. Twenty-seven were histopathologically confirmed thyroglossal duct remnant and remaining three patients were dermoid cyst and tuberculous lymphadenopathy and were excluded from the study. The sex distribution was almost equal. The commonest age group affected by TGDR was less than twenty years (70.38 %) and commonest site was midline subhyoid (85.19 %). The post-operative complication rate of thyroglossal duct remnant was 18.51 % in the present study. Thyroglossal duct remnant is the commonest congenital cervical lesion in the pediatric population. Other clinical conditions of neck can masquerade as thyroglossal duct remnant so histopathological confirmation is mandatory. Sistrunk operation is the standard treatment to minimize recurrence.

Primary papillary carcinoma of the thyroglossal duct cyst--a case report.

Thyroglossal duct cyst is the most common developmental anomaly of the thyroid gland, presenting as a mid line neck swelling. Malignancy arising in them is a rare event, with papillary thyroid carcinoma being the commonest. Thyroglossal duct cyst carcinomas are usually asymptomatic and are not suspected preoperatively in most instances, hence the need for surgical excision and careful pathological examination of these cysts. We present a case of a 57 year old lady who underwent a Sistrunk procedure for the removal of thyroglossal duct cyst, which was responsible for a progressive mid line neck swelling of 2 months duration. The thyroid gland was normal. Histological examination of the excised cyst showed a papillary thyroid carcinoma arising in the thyroglossal duct cyst. Long term survival of patients with thyroglossal duct cyst carcinoma is excellent.

Thyroglossal duct cyst. A clinicopathological study of five cases

Thyroglossal duct cyst [TGDC] is the most common non-odontogenic cyst In the neck. It Is a lesion mainly detected In childhood but which may elude detection until adulthood. When such TGDC presents in adulthood, It Is often seen by maxillofacial surgeons and Its appearance may not necessarily conform to the classic description of the lesion. This paper presents five case reports Of TGDC seen In the Department of Oral and Maxillofacial Surgery In the Riyadh Medical Complex and emphasizes the difference In clinical appearance between those lesions presented to the Pediatric and Maxillofacial Surgery departments, respectively. It also discusses the different diagnostic tools for and differential diagnoses of the lesion

Quiste del conducto tirogloso: caso clínico

Se relata el caso de un paciente de 4 años, quien desde los 3 años presentó una masa en la región cervical de crecimiento progresivo. Hace 9 meses presentó tos, disfonía, disfagia e hipopirexia, manifestaciones que se exacerbaron en los últimos 3 meses. Previa la consulta alza térmica (38,5ïC), tos no productiva, odinodisfagia y adinamia; al examen físico orofaringe congestiva, amígdalas hipertróficas, masa renitente de 3x2x3 cm ubicada a nivel de la línea media en la región cervical anterior, no dolorosa a la palpación y no adherida a planos profundos; además adenomegalia cervical de la cadena superior. En los exámenes complementarios y de imagen, la ultrasonografía cervical demostró la presencia de una masa quística...

Cisto do ducto tireoglosso associado a cisto branquial: relato de caso e revisäo da literatura / Thyroglossal duct cyst and branchial cyst: case report and literature review

O cisto do ducto tireoglosso é uma das mais freqüentes anomalias congênitas do pescoço. As afecções branquiais são um terço menos freqüentes que os cistos do ducto tireoglosso. Este relato de caso descreve um paciente com um cisto do ducto tireoglosso concomitante com restos branquiais. Foi submetido à cirurgia com sucesso e o diagnóstico definido pelo exame histopatológico. O possível desenvolvimento embiológico de cada patologia é discutido, e a revisão da literatura mostra que este é um caso raro. O achado de variações de apresentação de afecções comuns pode ser maior do que supõe.