Modified Sistrunk procedure in a pediatric population: Infected thyroglossal duct cysts as a risk factor for recurrence and review of the literature

Thyroglossal duct cysts (TDCs) arise in roughly 7% of the general population and are typically diagnosed in childhood within the first decade of life. Typically, patients present with a painless, midline neck mass in close proximity to the hyoid bone which classically elevates with deglutition and tongue protrusion. We present a case of TDC found anterior to the sternum, a major deviation from the classical understanding of this lesion. The patient was treated successfully with modified Sistrunk procedure. This case underscores the need for clinicians to maintain a wide differential while working up paediatric patients presenting with neck masses. Furthermore, we emphasise that TDC must always be considered in cases of midline paediatric neck masses, even when found in unusual locations such as presented here.

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Thyroglossal duct cyst: myriad presentations

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20192715 ◽

2019 ◽

Vol 5 (4) ◽

pp. 973

Author(s):

S. Meenakshi ◽

M. K. Rajasekar

Keyword(s):

Retrospective Study ◽

Postoperative Period ◽

Revision Surgery ◽

Thyroglossal Duct Cyst ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Normal Thyroid ◽

Delayed Healing ◽

Sistrunk Procedure ◽

Thyroglossal Duct Cysts

Background: Thyroglossal duct cysts are the most common midline neck swellings. They are routinely treated by surgeons with simple excision.Methods: We present a retrospective study of a series of 30 cases operated in our hospital over a period of five years and the challenges faced during investigations, surgery and postoperative period. All patients were clinically diagnosed as thyroglossal duct cysts. The diagnosis confirmed with USG Neck and FNAC of the swelling. CECT NECK was used to delineate the normal thyroid and patients were subjected to Sistrunk procedure under general anesthesia.Results: The outcome of all cases was good with one case being a revision surgery and another case going in for delayed healing due to infection. All patients were healthy with no complaints postoperatively.Conclusions: This study validates the Sistrunk surgery as the best method of excision to avoid recurrences. This article highlights the variant presentations of this cyst in our institution and the challenges we faced in diagnosis, during surgery and later as well.

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Possible Risk Factors for Recurrence After Removal of Thyroglossal Duct Cysts with the Sistrunk Procedure

kulak burun boğaz ve baş boyun cerrahisi dergisi ◽

10.24179/kbbbbc.2020-78097 ◽

2020 ◽

Vol 28 (3) ◽

pp. 275-281

Author(s):

Muammer Melih ŞAHİN ◽

Süleyman CEBECİ ◽

Eray UZUNOĞLU ◽

Gökçen CESUR ◽

Mehmet DÜZLÜ ◽

...

Keyword(s):

Risk Factors ◽

Thyroglossal Duct ◽

Sistrunk Procedure ◽

Risk Factors For Recurrence ◽

Thyroglossal Duct Cysts

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Wide anterior neck dissection for management of recurrent thyroglossal duct cysts in adults

The Journal of Laryngology & Otology ◽

10.1017/s0022215116008239 ◽

2016 ◽

Vol 130 (S4) ◽

pp. S41-S44 ◽

Cited By ~ 2

Author(s):

L M O'Neil ◽

D A Gunaratne ◽

A T Cheng ◽

F Riffat

Keyword(s):

Neck Dissection ◽

Thyroglossal Duct Cyst ◽

Anterior Neck ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Sistrunk Procedure ◽

Cyst Recurrence ◽

Thyroglossal Duct Cysts ◽

Dissection Technique

AbstractObjective:Thyroglossal duct cyst recurrence following resection is attributed to anatomical variability and residual thyroglossal ducts. In adults, thyroglossal duct cyst recurrence is extremely rare and a surgical solution is yet to be well explored. This paper describes our approach to the management of recurrent thyroglossal duct cysts and sinuses in adults using a wide anterior neck dissection.Method:A retrospective review was performed to identify adults who underwent a wide anterior neck dissection for recurrent thyroglossal duct cyst management between 1 January 2009 and 1 January 2015.Results:Six males and one female were included in the series (mean age, 26.4 ± 10.9 years). Recurrence occurred at a mean of 18 ± 9.8 months following primary surgical management (3 patients underwent cystectomy and 4 had a Sistrunk procedure). All patients subsequently underwent wide anterior neck dissection; there was no further recurrence over the 12-month average follow-up period.Conclusion:This paper describes a wide anterior neck dissection technique for the management of recurrent thyroglossal duct cysts or sinuses in adults; this approach addresses the variable anatomy of the thyroglossal duct and is associated with minimal morbidity.

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Papillary Thyroid Carcinoma Identified after Sistrunk Procedure: Report of Two Cases and Review of the Literature

Tumori Journal ◽

10.1177/030089160308900221 ◽

2003 ◽

Vol 89 (2) ◽

pp. 207-210 ◽

Cited By ~ 9

Author(s):

Paolo Aluffi ◽

Massimiliano Pino ◽

Renzo Boldorini ◽

Francesco Pia

Keyword(s):

Lymph Node ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Thyroid Tissue ◽

Surgical Approaches ◽

Papillary Thyroid ◽

Duct Carcinoma ◽

Thyroglossal Duct ◽

Sistrunk Procedure ◽

Thyroglossal Duct Cysts

Thyroglossal duct cysts represent the most common congenital cervical malformations. Carcinomas arising in the thyroglossal duct cysts are rare neoplasms characterized by a relatively non aggressive behavior with rare lymph node spread. Approximately 1% of thyroglossal cysts contain a carcinoma. The most frequent histological type is papillary carcinoma, accounting for about 80% of cases. Currently, most authors agree about their primary origin ex novo from ectopic thyroid tissue in the cyst. In most cases the diagnosis of thyroglossal duct carcinoma (TDC) is not made until histopathological examination has been performed on a resected cyst without any suspected clinical sign of malignancy. The definition of the correct surgical treatment for these carcinomas is still controversial; most authors maintain that resection of a TDC with the Sistrunk procedure can be considered oncologi-cally adequate when dealing with a differentiated carcinoma without extracapsular invasion and/or lymph node metastases and with a normal thyroid. We present two cases of papillary thyroid carcinoma identified after resection of a thyroglossal cyst according to the Sistrunk procedure and managed with different surgical approaches according to the different sites of the tumors. In addition, we discuss appropriate therapeutic strategies in light of the most recent data in the literature.

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“Extended” Sistrunk procedure in the treatment of recurrent thyroglossal duct cysts: A 10-year experience

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2014.06.029 ◽

2014 ◽

Vol 78 (9) ◽

pp. 1534-1536 ◽

Cited By ~ 8

Author(s):

Valentina Pastore ◽

Fabio Bartoli

Keyword(s):

Thyroglossal Duct ◽

Sistrunk Procedure ◽

Thyroglossal Duct Cysts

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The Central Neck Dissection or the Modified Sistrunk Procedure in the Treatment of the Thyroglossal Duct Cysts in Children: Our Experience

BioMed Research International ◽

10.1155/2018/8016957 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Beata Pucher ◽

Katarzyna Jonczyk-Potoczna ◽

Agata Kaluzna-Mlynarczyk ◽

Pawel Kurzawa ◽

Jaroslaw Szydlowski

Keyword(s):

Neck Dissection ◽

Surgical Techniques ◽

Central Neck Dissection ◽

Central Neck ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Infected Cyst ◽

History Of ◽

Sistrunk Procedure ◽

Thyroglossal Duct Cysts

Background. The aim of the study was to present the surgical techniques providing the lowest recurrence rate in treatment of the primary and recurrent thyroglossal duct cyst (TGDC) in children. Methods. The study included 73 patients operated on because of TGDC in years 2011–2016. Ultrasound was performed in all patients preoperatively. In 8 patients with the recurrence of the disease, the CT or MR was carried out before the surgery. Children with the primary disease underwent the modified Sistrunk procedure. In the revision cases the central neck dissection was a method of choice. Results. In 45 children, the modified Sistrunk procedure was performed and 28 underwent the central neck dissection. In 2 patients, hematoma occurred after the modified Sistrunk procedure with the need of the surgical revision in one. No complications were observed after the central neck dissection. Conclusions. A modified Sistrunk procedure is method of choice in the treatment of the uncomplicated TGDC. In selected cases of the TGDC with a history of infected cyst or incision of an abscess or in revision cases the central neck dissection should be considered in order to avoid the risk of the further recurrences.

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Thyroglossal Cyst Papillary Carcinoma: What Next Step must be done?

International Journal of Phonosurgery & Laryngology ◽

10.5005/jp-journals-10023-1137 ◽

2017 ◽

Vol 7 (1) ◽

pp. 23-26

Author(s):

Jagdeep S Thakur

Keyword(s):

Total Thyroidectomy ◽

Papillary Carcinoma ◽

Thyroglossal Cyst ◽

Papillary Cancer ◽

Thyroglossal Duct ◽

Histopathological Findings ◽

Sistrunk Procedure ◽

Thyroglossal Duct Cysts

ABSTRACT Thyroglossal duct cysts (TGDCs) are usually midline structure of the neck. The coexistence of carcinomas in TGDCs is found rarely, with most being papillary carcinomas. Usually, the diagnosis is made postoperatively after excision of the cyst. Although the Sistrunk procedure is often regarded as adequate, various controversies exist concerning the need for thyroidectomy depending on histopathological findings. We are reporting the case of a 56-year-old man, diagnosed with papillary carcinoma within a TGDC, who underwent total thyroidectomy as has been recommended for differentiated papillary cancer. How to cite this article Gupta R, Mohindroo NK, Azad R, Thakur JS. Thyroglossal Cyst Papillary Carcinoma: What Next Step must be done? Int J Phonosurg Laryngol 2017;7(1):23-26.

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