A mixed thyroglossal cyst

The case is described of a boy who presented at age six months with symptoms and signs of a thyroglossal cyst, which seemed to be confirmed by ultrasound findings. The cyst slowly increased in size, and eventually the patient underwent Sistrunk’s procedure at age four years. Histology showed that the cyst was in fact a mixed thyroglossal and dermoid cyst. This casts doubt on the doctrine that thyroglossal cysts and dermoid cysts are anatomically and histologically separate entities, and strengthens the view that these cysts should be more appropriately named ’thyroglossal abnormalities’.

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Congenital Anomalies Presenting as Head-Neck Swellings: A Study of 50 Cases

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v23i2.45164 ◽

2020 ◽

Vol 23 (2) ◽

pp. 171-179

Author(s):

Md Zahidul Islam ◽

Md Abdur Rahman ◽

Md Sirajul Islam Mahfuz

Keyword(s):

Dermoid Cyst ◽

Branchial Arch ◽

Medical College Hospital ◽

Sex Distribution ◽

Thyroglossal Cyst ◽

College Hospital ◽

Female Ratio ◽

Medical College ◽

Male To Female ◽

Head Neck

Purpose: To analyse the prevalence, distribution and presentation of different congenital head-neck lesions with their age, sex, site and side predilection. Methods: 50 patients of head-neck congenital swelling was selected from january/2013 upto december/2013 in the OPD of otorhino-laryngology, head and neck deptt. of Dhaka medical college hospital under a specific prospective study protocol. Results: The most frequent swelling was thyroglossal cyst(42%), followed by branchial arch anomalies (18%),dermoid cyst(14%),pre-auricular sinus(14%),lymphangioma(8%) and haemangioma(4%).Amongst the cervical swellings the sequential preponderence was thyroglossal cyst(52%),branchial arch anomalies(23%),dermoid cyst(13%), lymphangioma(10%) and haemangioma (2%).The majority of branchial arch anomalies(100%) were of second arch. The majority of patients were of first(52%) and second(30%) decade and the male to female ratio for thyroglossal cysts was 1:1.1.The majority of lesions were painless swelling and all were surgically excised. Conclusion: The overall frequency and age-sex distribution of congenital head-neck swellings as well as site, nature and type specific predominance of some of them in OPD of Dhaka medical college hospital are almost similar to international findings. Bangladesh J Otorhinolaryngol; October 2017; 23(2): 171-179

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Concurrent Papillary Carcinoma of Thyroglossal Duct Cyst and Thyroid Isthmus, Beyond the Sistrunk Procedure

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1813 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A888-A888

Author(s):

Aiman Riaz ◽

Aysha Khan ◽

Azad Jabiev ◽

Ibitoro Nnenna Osakwe

Keyword(s):

Lymph Node ◽

Total Thyroidectomy ◽

Central Compartment ◽

Thyroglossal Duct Cyst ◽

Braf V600e ◽

Papillary Thyroid ◽

Thyroglossal Cyst ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Sistrunk’S Procedure

Abstract Introduction/Background: Papillary carcinoma (PC) originating from the thyroglossal cyst is a rare entity. It is even more uncommon to have concurrent thyroglossal duct cyst PC and papillary thyroid carcinomas (PTC). The surgical approach for such patients would involve a combination of a Sistrunk’s procedure and total thyroidectomy. We describe management of a patient found to have multi focal PC originating from a thyroglossal duct cyst and thyroid isthmus with extensive cervical lymph node metastasis. Clinical Case: 30-year-old male presented to PCP with palpable bilateral cervical adenopathy most prominent in the right supraclavicular region. Neck ultrasound confirmed multiple metastatic appearing nodes (largest 4cm) in the central, right and left lateral cervical compartments as well as a hypoechoic, TI-RADS category 5 right thyroid isthmus nodule. FNA of the cervical nodes confirmed metastatic PTC. Neck CT in addition to extensive cervical adenopathy revealed a 2 cm solid mass inferior to the central hyoid bone with infiltrative borders and calcifications suspicious for a primary tumor. Patient underwent total thyroidectomy with central compartment lymph node dissection, excision of thyroglossal cyst and bilateral modified radical neck dissections. Histopathology report revealed a 2.4 cm thyroglossal duct tumor and a 1.1 cm tumor in the thyroid isthmus, confirming two separate tumors both being classical variants of papillary thyroid carcinoma, with no lympho-vascular invasion and 8/53 positive lymph nodes. BRAF V600E mutation was positive. On follow up, the patient is doing well and has deferred adjuvant radioactive iodine treatment for 6 months for personal reasons. Clinical Lesson/ Conclusion: PC of the thyroglossal cyst with synchronous isthmic PTC merits total thyroidectomy and central compartment dissection in addition to the Sistrunk’s procedure, as the likelihood of local metastasis is high. Presence of BRAF V600E mutation has been identified as a predictor of more aggressive behavior in isolated PC of the thyroglossal duct cyst, suggesting a need for more than a Sistrunk’s procedure in such patients. Our patient, who presented with local lymph node metastasis supports this conclusion. Determining BRAF mutation status preoperatively may be a helpful strategy in planning the extent of surgery. Keywords Thyroglossal duct cyst, Papillary thyroid carcinoma, BRAF mutation

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Clinicopathological study of pediatric neck masses

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180504 ◽

2018 ◽

Vol 4 (2) ◽

pp. 343

Author(s):

Navneeta Gangwar ◽

Pratibha Vyas ◽

Saurabh Gakkar

Keyword(s):

Dermoid Cyst ◽

Outpatient Clinic ◽

Clinical Presentation ◽

Thyroglossal Cyst ◽

Sequential Approach ◽

Hodgkins Lymphoma ◽

Neck Masses ◽

Clinicopathological Analysis ◽

Clinicopathological Study ◽

Non Hodgkins Lymphoma

Background: Pediatric neck masses are a reason for anxiety for both patients and doctor as there can be chances of malignancy. There are few established guidelines for evaluation. The etiology is varied so a thorough knowledge of clinical presentation is essential. Methods: A clinicopathological analysis of 150 cases of neck masses in children upto 12 years of age attending the outpatient clinic between Jan 2015 to June 2016 were included. Results: Maximum cases of reactive lymphadenopathy were found in our study 81 (20.7%), 23 (14.7%) thyroglossal cyst, 22 (14.7%) suppurative lymphadenopathy, mycobacterial lymphadenitis 20 (13.3%), dermoid cyst 17 (11.3%), branchial cyst 15 (10%), tubercular abscess 10 (6.7%), 3 cases (2%) each of Hodgkins lymphoma, lipoma, non-Hodgkins lymphoma were seen. FNAC was conclusive in 140 cases (93.4%). Conclusions: Percentage wise inflammatory etiology was the commonest (55.4%) followed by congenital (38.6%) and last was neoplastic (6 %). An orderly and sequential approach is needed to manage pediatric masses.

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Questions and Answers

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2000.marapr02 ◽

2000 ◽

Vol 5 (2) ◽

pp. 3-3

Author(s):

Christopher R. Brigham ◽

James B. Talmage

Keyword(s):

Nervous System ◽

Peripheral Nervous System ◽

Spinal Nerve ◽

Sensory Loss ◽

Residual Symptoms ◽

Additional Information ◽

Questions And Answers ◽

Motor Nerves ◽

Symptoms And Signs ◽

Limited Motion

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) describes procedures for rating upper extremity neural deficits in Chapter 3, The Musculoskeletal System, section 3.1k; Chapter 4, The Nervous System, section 4.4 provides additional information and an example. The AMA Guides also divides PNS deficits into sensory and motor and includes pain within the former. The impairment estimates take into account typical manifestations such as limited motion, atrophy, and reflex, trophic, and vasomotor deficits. Lesions of the peripheral nervous system may result in diminished sensation (anesthesia or hypesthesia), abnormal sensation (dysesthesia or paresthesia), or increased sensation (hyperesthesia). Lesions of motor nerves can result in weakness or paralysis of the muscles innervated. Spinal nerve deficits are identified by sensory loss or pain in the dermatome or weakness in the myotome supplied. The steps in estimating brachial plexus impairment are similar to those for spinal and peripheral nerves. Evaluators should take care not to rate the same impairment twice, eg, rating weakness resulting from a peripheral nerve injury and the joss of joint motion due to that weakness.

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