Thyroglossal duct cyst anterior to the sternum: a novel presentation of a common lesion

2020 ◽  
Vol 13 (11) ◽  
pp. e236515
Author(s):  
Jordan Whitney Rawl ◽  
Nicholas Armando Rossi ◽  
Matthew G Yantis ◽  
Wasyl Szeremeta

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.

1986 ◽  
Vol 95 (1) ◽  
pp. 93-98 ◽  
Author(s):  
Robert F. Ward ◽  
Robert W. Selfe ◽  
Leslie St. Louis ◽  
David Bowling

Thyroglossal duct cysts (TDC) classically present as midline neck masses in close relation to the hyoid bone; yet—not uncommonly—their locations may be varied from the midline and from the hyoid. By means of the diagnostic modality of computed tomography (CT), high-resolution images of several cases of alternate presentations and locations of the TDC are examined. Included are examples of TDC in the suprahyoid, transhyoid, infrahyoid, and lateral positions. The potential value of CT in the diagnosis of the unusual cyst will be demonstrated and discussed.


2020 ◽  
Vol 129 (12) ◽  
pp. 1239-1242
Author(s):  
Marisa A. Ryan ◽  
Jonathon O. Russell ◽  
Desi P. Schoo ◽  
Patrick A. Upchurch ◽  
Jonathan M. Walsh

Objective: Thyroglossal duct cysts (TGDCs) are relatively common congenital midline neck masses that are treated with surgical excision. Traditionally these are removed along with any associated tract and the central portion of the hyoid bone through an anterior neck incision. Some patients with TGDCs want to avoid an external neck scar. Methods: We describe the details of a transoral endoscopic vestibular excision of a TGDC and the associated hyoid bone in an adolescent patient. Results: This novel approach was successful and there were no complications. Conclusion: We propose that cervical TGDCs can be safely and completely removed with this approach in appropriately selected patients while avoiding a neck scar.


2005 ◽  
Vol 71 (6) ◽  
pp. 508-511 ◽  
Author(s):  
Pradeep S. Mohan ◽  
Ravi A. Chokshi ◽  
Robert L. Moser ◽  
Sadeq A. Razvi

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.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Diani Kartini ◽  
Sonar S. Panigoro ◽  
Agnes S. Harahap

A thyroglossal duct cyst is a lesion that occurs as a result from failure of the thyroglossal duct to obliterate during fetal development. Malignant progression is a rare event that might occur in less than 1% of all cases. Because of its rarity, there are conflicting opinions regarding the management of the case. In the present study, a 46-year-old male presented with a painless neck mass that had increased in size over the last 6 months. There was no difficulty in swallowing and breathing, change in voice, significant weight loss, or any signs of hyperthyroidism. Laboratory workup showed that results were within normal limits. Thyroid gland ultrasonography and cervical contrast CT scan revealed a complex cystic mass that pointed towards a thyroglossal duct cyst. We performed Sistrunk procedure. Postoperative pathology examination revealed microscopic appearance of the thyroglossal duct cyst with a classic follicular variant of papillary thyroid carcinoma. Our latest follow-up showed no signs of tumor recurrence or any complications following surgery on locoregional status. As a fine needle aspiration biopsy cannot ensure a precise result in all of cases, it is essential to perform a solid physical examination and thorough supporting examination in deciding the precise management for the patient.


2019 ◽  
Vol 2019 (11) ◽  
Author(s):  
John Kerr ◽  
Weston L Niermeyer ◽  
Peter B Baker ◽  
Tendy Chiang

Abstract A thyroglossal duct cyst (TGDC) is a common pediatric midline neck mass. Most TGDCs occur in the region of the hyoid bone but have been found less commonly in areas from the oral cavity to the sternum. We present the first reported case of a multifocal floor of mouth (FOM)/cervical TGDC representing an atypical embryonic course. We also review atypical presentations of TGDC and provide a summary of cases involving FOM and multifocal cysts.


2020 ◽  
Vol 129 (6) ◽  
pp. 628-632
Author(s):  
Samuel Bosco ◽  
Jason E. Cohn ◽  
Marissa Evarts ◽  
Paul Papajohn ◽  
Raymond Lesser

Objective: Thyroglossal duct cysts are the most common congenital neck mass. They typically present as a painless midline neck mass in a child or young adult, but may also present later in adulthood when the cyst becomes symptomatic. Thyroglossal duct cysts are most commonly located inferior to the hyoid bone in close relation with the thyrohyoid membrane. Very rarely, they may extend intralaryngeal, occupy the posterior hyoid space, and present with dysphonia and/or dysphagia. To our knowledge, this is the 24th reported case in the literature. Methods: Case report with a comprehensive review of the literature. Results: The patient was a 43-year-old male experiencing dysphonia and dysphagia following a motor vehicle accident. He was subsequently found to have a large thyroglossal duct cyst with endolaryngeal extension that was previously asymptomatic and undiagnosed. He underwent successful surgical excision which resulted in resolution of symptoms. Conclusion: This is the first reported case of a thyroglossal duct cyst in the posterior hyoid space with endolaryngeal extension being diagnosed following a traumatic event. This case illustrates the need to consider thyroglossal duct cyst in the differential diagnosis when working up a post-traumatic intralaryngeal neck mass. A secondary educational objective in this case is to be diligent to consider and rule out laryngeal fracture in the case of a neck mass presenting after trauma as they can easily be missed and present with many overlapping symptoms.


1996 ◽  
Vol 75 (8) ◽  
pp. 530-534 ◽  
Author(s):  
Eugene G. Brown ◽  
Marcus S. Albernaz ◽  
Mark T. Emery

Thyroglossal duct cysts, though not uncommon, rarely present with evidence of laryngeal compromise. The case presented is one of the very few cases with documented laryngeal invasion reported in the English language. Of clinical significance is the patient's presentation with laryngeal symptoms of choking and dysphonia in the presence of a small anterior cervical mass. While the thyroglossal duct cyst usually presents as an asymptomatic anterior neck mass, this case illustrates the importance of considering a thyroglossal duct cyst in any patient with airway compromise in the absence of a neck mass.


Author(s):  
Duha Hejla ◽  
◽  
Erella Elkon-Tamir ◽  
Li-tal Pratt ◽  
Oshri Wasserzug ◽  
...  

Thyroglossal duct cysts are the most common congenital abnormality in the neck, accounting for 70-75% of midline neck masses in children [1]. Late in the 4th week of gestation, the thyroid anlage develops as a small, solid mass of endoderm proliferating at the foramen cecum. As the thyroid anlage descends caudally in the neck, it maintains an attachment to the site of origin at the level of the foramen cecum of the tongue via the thyroglossal duct [2]. The thyroglossal duct typically involutes and atrophies between 7 and 10 weeks of gestation by the time the thyroid gland reaches its final position inferior to the cricoid cartilage [2]. The source of TGDC is believed to be persistent remnants of the thyroglossal duct. Due to the communication of the duct to the mouth via the foramen cecum, thyroglossal cysts can become infected with oral flora. One-third of patients of all ages will present with a concurrent or prior infection, and one-quarter will present with a draining sinus from spontaneous or incisional drainage of an abscess [3]. The cysts occur almost equally in both sexes [4,5].


Author(s):  
S. Meenakshi ◽  
M. K. Rajasekar

<p class="abstract"><strong>Background:</strong> Thyroglossal duct cysts are the most common midline neck swellings. They are routinely treated by surgeons with simple excision.</p><p class="abstract"><strong>Methods:</strong> 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.</p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>


2020 ◽  
Vol 18 (2) ◽  
pp. 121-126
Author(s):  
Abhishek Bhardwaj ◽  
◽  
Kartikesh Gupta ◽  
Manu Malhotra ◽  
Madhu Priya ◽  
...  

Introduction. Thyroglossal duct cyst (TDC) is the most common cause of congenital neck mass. These can present anywhere from foramen caecum to mediastinum. Usually presents as a solitary cyst, the double thyroglossal cyst is very rare and a triple thyroglossal cyst has never been reported. Aim. Herein, we report an atypical case of triple thyroglossal cyst, at levels of hyoid, thyrohyoid membrane and thyroid isthmus managed surgically without any complication. Description of the case. We are presenting case of a 48-year-old female who presented to us with the complaint of anterior neck swelling since birth. On work up it was diagnosed as a case of the thyroglossal duct cyst and was intraoperatively found to have 3 distinct cystic swellings connected to a common stalk lying beneath the hyoid. It was successfully treated by modified Sistrunk’s procedure. There was no evidence of recurrence on follow up for 6 months. Considering atypical presentations, there are 9 cases reported with the double thyroglossal duct cyst, TDC within the thyroid gland and sublingual TDC. Such presentations make the diagnosis more challenging, leading to improper treatment. Conclusion. We are presenting this case as there is no case reported in English literature with a triple thyroglossal duct cyst. An awareness that thyroglossal cyst can present as multiple cysts is important for clinician in order to perform correct surgical management and to avoid the most feared complication of recurrence.


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