Thyroglossal Duct Cyst Causing Airway Obstruction in an Adult

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.

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.


2021 ◽  
pp. 014556132110220
Author(s):  
Po-Kai Huang ◽  
Li-Chun Hsieh ◽  
Yi-Shing Leu

Thyroglossal duct cysts are typically benign and usually asymptomatic. Malignant transformation is uncommon. Intralaryngeal extension is rare and results in dysphonia or dyspnea. There is no literature nowadays reporting the thyroglossal duct cyst carcinoma combining the clinical features of intralaryngeal extension. The authors present a case of progressive hoarseness and midline neck mass for 2 years. The laryngoscope and computed tomography revealed a 6-cm thyroglossal duct cyst containing ectopic thyroid tissue with intralaryngeal extension and causing airway obstruction. Complete excision with Sistrunk operation revealed papillary thyroid carcinoma. The patient resumed normal phonation after the surgery. There was no evidence of tumor recurrence and no hoarseness or dyspnea at 6 months follow up. This is the first reported case of a huge thyroglossal duct cyst carcinoma with intralaryngeal extension causing airway compromise. Complete excision of tumor is essential and vital to the symptom relief. A thyroglossal duct cyst carcinoma with endolaryngeal involvement should be considered in the differential diagnosis when the case has a massive midline neck mass with ectopic thyroid tissue and develops dyspnea or hoarseness concurrently.


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.


2011 ◽  
Vol 126 (2) ◽  
pp. 217-220 ◽  
Author(s):  
J Madana ◽  
R Kalaiarasi ◽  
D Yolmo ◽  
S Gopalakrishnan

AbstractObjective:We report an extremely rare case of the simultaneous occurrence of a thyroglossal duct cyst and a lingual thyroid in the absence of an orthotopic thyroid gland, in a seven-year-old girl from South India.Method:Case report and a review of the English language literature on the subject.Results:The patient presented with a mass on the tongue that had been present for three years, and an anterior neck swelling that had been present for two years. Examination revealed a midline, pinkish, firm mass present on the posterior one-third of the tongue. The neck showed a midline cystic swelling in the infrahyoid position. Radiological imaging confirmed the clinical findings, revealing the absence of her thyroid gland in the normal location. Sistrunk's procedure was performed leaving behind a lingual thyroid. At 13-month follow up, the patient was euthyroid with no recurrence.Conclusion:To our knowledge the association of a lingual thyroid and a thyroglossal cyst has only been reported once in the literature. The presence of a lingual thyroid in the absence of a normally located thyroid gland or functioning thyroid tissue along the thyroglossal tract, confirmed by radionuclide and computed tomography imaging, may indicate the failure of the normal descent of the thyroid gland during embryonic development. This probable absence of the descent of the thyroid raises questions regarding the origin of thyroglossal duct 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.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A895-A896
Author(s):  
Raghda Al Anbari ◽  
Majlinda Xhikola ◽  
Sushma Kadiyala

Abstract A 55-year-old female with medical history of hypothyroidism and fibrocystic disease of the breast presented with complains of a painful anterior neck mass, difficulty swallowing and hoarseness of the voice. Symptoms had progressed over a period of 5 months. CT neck with contrast indicated the presence of an ectopic thyroid tissue anterior to the thyroid cartilage measuring approximately 1.7 x 1.2 x 3.1 cm, with indistinct inferior margins and internal calcifications. The hyoid bone or thyroid cartilage had no irregularities. The thyroid gland itself was unremarkable except for small complex thyroid nodules in both lobes. No masses within the pharynx or larynx were noted. Family history was significant for lymphoma in her father. On physical exam, a hard, mobile right anterior neck mass was appreciated. Labs showed normal TSH of 1.05 uIU/mL and normal free T4 of 1.2 ng/dL. Further evaluation with a dedicated neck US showed a right submandibular mass, superior to the thyroid, lobulated and heterogeneous measuring 2.0 x 1.0 x 2.3 cm with multiple areas of calcifications and internal Doppler flow. The thyroid gland had normal size and texture with bilateral sub centimeter non-concerning nodules. After ENT evaluation and an unremarkable flexible fiberoptic nasolaryngoscope, patient underwent surgical excisional biopsy of the neck mass. Pathology was consistent with thyroglossal duct cyst with the presence of thyroid follicles. An incidental finding of a 0.9 cm papillary microcarcinoma was noted, which was encapsulated with focal extracapsular follicular structures showing papillary nuclear features with no perineural or lymphovascular invasion. The tumor cells were immunoreactive for TTF-1 and PAX8. Development of papillary thyroid cancer within the thyroglossal duct cyst is a rare event, reportedly occurring in 1% of thyroglossal duct cysts. There are no well-established management guidelines. Current management strategies consist of monitoring with serial neck ultrasound versus total thyroidectomy with consideration of postsurgical I-131 treatment, based on pathology results. Our patient opted for undergoing total thyroidectomy.


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.


2016 ◽  
Vol 130 (S4) ◽  
pp. S41-S44 ◽  
Author(s):  
L M O'Neil ◽  
D A Gunaratne ◽  
A T Cheng ◽  
F Riffat

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.


2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Niranjan Tachamo ◽  
Brian Le ◽  
Jeffrey Driben ◽  
Vasudev Magaji

Thyroglossal duct cyst carcinoma is rare and occurs in just 1% of cases with thyroglossal duct cysts. It is not always possible to distinguish a thyroglossal cyst harboring malignancy from its benign counterparts unless biopsied, thus posing the dilemma. Currently there is no clear consensus on the optimal management of thyroglossal duct cyst carcinoma. Here we present the case of a 69-year-old female who presented with a midline neck mass and dysphagia and was found to have papillary thyroid cancer in the biopsy specimen of the neck mass. She underwent excision of the mass and the thyroglossal duct cyst along with total thyroidectomy; however, the thyroidectomy specimen showed no malignancy. Her lymph node mapping was negative and she is awaiting radioactive iodine treatment.


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.


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