Diagnostic Approach to Congenital Cystic Masses of the Neck from a Clinical and Pathological Perspective

Background: neck cysts are frequently encountered in pediatric medicine and can present a diagnostic dilemma for clinicians and pathologists. Several clinical items enable to subclassify neck cyst as age at presentation, anatomical location, including compartments and fascia of the neck, and radiological presentation. Summary: this review will briefly describe the clinical, imaging, pathological and management features of (I) congenital and developmental pathologies, including thyroglossal duct cyst, branchial cleft cysts, dermoid cyst, thymic cyst, and ectopic thymus; (II) vascular malformations, including lymphangioma. Key Messages: pathologists should be familiar with the diagnostic features and clinicopathologic entities of these neck lesions in order to correctly diagnose them and to provide proper clinical management.

Download Full-text

Infected Thyroglossal Duct Cyst – A Diagnostic Dilemma

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/418 ◽

2021 ◽

Vol 10 (27) ◽

pp. 2044-2047

Author(s):

Ramhari Shankarrao Sathawane ◽

Kshitija Sanjay Bhakte ◽

Prajkta Sathawane Moharkar ◽

Vidyarjan Ashok Sukhadeve ◽

Mrunali Gajanan Chincholkar

Keyword(s):

Clinical Diagnosis ◽

Histopathological Examination ◽

Imaging Modality ◽

Neck Mass ◽

Thyroglossal Duct Cyst ◽

Diagnostic Dilemma ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Neck Masses ◽

Cystic Masses

Neck swellings are usually the most visible and noticeable pathologies. These swellings include enlarged lymph nodes, swellings of thyroid gland, congenital / developmental cysts and lipomas.1 Cystic congenital neck masses are usually very well diagnosed in childhood. Congenital cystic masses of the anterior neck include thyroglossal duct cyst (TDC), branchial cleft cyst & cystic hygromas from uncommon pathologies to very rare thymic and bronchogenic cysts.2 Painless and soft or fluctuant nature of neck mass is usually the first clinical presentation in most cases. Ultrasonography (USG) helps to define the size, shape and extent of mass and confirms the cystic nature of lesion, whereas histopathological examination is the gold standard.3 The purpose of this article is to impress upon all that USG is an adjuvant imaging modality which helps in diagnosing cystic nature of the neck lesions. But most of the time, it cannot differentiate between dermoid cyst and thyroglossal cyst. The present case of infected thyroglossal duct cyst was reported to have diagnostic dilemma between clinical diagnosis and sonographic diagnosis. Histopathological examination confirmed the clinical diagnosis of Infected TDC.

Download Full-text

Sonographic evaluation of congenital cystic neck masses with histopathological correlation

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v24i1.45344 ◽

2020 ◽

Vol 24 (1) ◽

pp. 68-78

Author(s):

Gazi Salahuddin ◽

Md Tarikul Islam ◽

Md Mahmudul Huq ◽

Sutanu Kumar Mondal ◽

Md Abdus Sobhan ◽

...

Keyword(s):

Cystic Hygroma ◽

Cystic Mass ◽

Thyroglossal Duct Cyst ◽

Cervical Region ◽

Branchial Cleft Cyst ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Congenital Lesions ◽

Congenital Lesion ◽

Branchial Cleft

Background: Accurate diagnosis is important for planning of management of the congenital cystic neck mass. Clinical history, physical examination and appropriate knowledge of embryology and anatomy of the cervical region frequently allow the differential diagnosis to be narrowed and ultrasound especially high frequency ultrasound help to further confirmation. USG has been used as the initial imaging procedure in the evaluation of them. Ultrasound not only confirms the cystic nature of the lesion but also evaluates exact location, size, extent, relation to the surrounding structures and internal characteristic of mass. Objectives: To establish the usefulness of ultrasound in the evaluation of congenital cystic neck masses. Methods: From January 2014 to March 2018 a total 50 patients with clinically suspected congenital cystic mass in the neck region were selected who under want operative treatment and histopathological examination. A through history taking and physical examination were done then patient were scanned with gray scale ultrasound and colour Doppler in necessary case. Histopathological report collected from the patient and compare with USG diagnosis. Results: In USG 37 patient diagnosed as congenital lesions and 13 patient diagnosed as non-congenital lesion. Among the congenital lesions thyroglossal duct cyst-19, branchial cleft cyst-12, cystic hygroma-4, hemangioma-1 and epidermoid cyst-1. In histopathology 32 patient diagnosed as congenital lesion and 18 diagnosed as non-congenital lesion. Among the congenital lesions thyroglossal duct cyst-18, branchial cleft cyst-8, cystic hygroma-4, hemangioma-1 and epidermoid cyst-1. Among the 19 USG diagnosed thyroglossal duct cyst 17 is confirmed by histopathology and 2 is differ. Among the 12 USG diagnosed branchial cleft cyst 7 is confirmed by histopathology and 5 is differ. Over all sensitivity of USG-93.7% and specificity-64% and accuracy-74%. Conclusion: USG is a useful modality for the diagnosis of congenital cystic mass in the cervical region. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 68-78

Download Full-text

Low-lying thyroglossal duct cyst with lateral cervical discharge masquerading as a second branchial cleft fistula: a case report

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2012.10.063 ◽

2013 ◽

Vol 48 (2) ◽

pp. 429-431 ◽

Cited By ~ 2

Author(s):

Sung-Min Hong ◽

Suk-Bae Moon

Keyword(s):

Case Report ◽

Thyroglossal Duct Cyst ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Branchial Cleft

Download Full-text

Ethanol Injection Sclerotherapy for Bakerʼs Cyst, Thyroglossal Duct Cyst, and Branchial Cleft Cyst

Annals of Plastic Surgery ◽

10.1097/00000637-199412000-00009 ◽

1994 ◽

Vol 33 (6) ◽

pp. 615-619 ◽

Cited By ~ 40

Author(s):

Keizo Fukumoto ◽

Tadao Kojima ◽

Hiroshi Tomonari ◽

Kinji Kontani ◽

Shigehiro Murai ◽

...

Keyword(s):

Thyroglossal Duct Cyst ◽

Injection Sclerotherapy ◽

Branchial Cleft Cyst ◽

Duct Cyst ◽

Ethanol Injection ◽

Thyroglossal Duct ◽

Branchial Cleft

Download Full-text

Unusual coexisting thyroglossal duct cyst and second branchial cleft fistula in an adult

Brazilian Journal of Otorhinolaryngology ◽

10.1016/j.bjorl.2015.11.017 ◽

2018 ◽

Vol 84 (3) ◽

pp. 398-399 ◽

Cited By ~ 1

Author(s):

Dong Hoon Lee ◽

Tae Mi Yoon ◽

Joon Kyoo Lee ◽

Sang Chul Lim

Keyword(s):

Thyroglossal Duct Cyst ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Branchial Cleft

Download Full-text

Fishbone-Associated Actinomycosis of the Anterior Cervical Space: A Diagnostic Dilemma

Case Reports in Medicine ◽

10.1155/2010/282167 ◽

2010 ◽

Vol 2010 ◽

pp. 1-3

Author(s):

Sang Kwon Lee ◽

Mi Jeong Kim ◽

Sun Young Kwon

Keyword(s):

Thyroglossal Duct Cyst ◽

Pathologic Examination ◽

Diagnostic Dilemma ◽

Duct Cyst ◽

Cervical Mass ◽

Strap Muscle ◽

Thyroglossal Duct ◽

Pathologic Findings ◽

Small Abscess

We report the imaging and pathologic findings of fishbone-associated actinomycosis of the anterior cervical space in a 57-year-old man, misdiagnosed preoperatively as a malignancy originating from thyroglossal duct cyst. CT revealed an enhancing mass containing a small abscess pocket and two sharp linear calcifications within it, which infiltrated into the strap muscle. Pathologic examination demonstrated two fishbones within the actinomycotic abscess. Fishbone-associated actinomycosis should be considered when a cervical mass contains sharp linear calcifications.

Download Full-text

Obstructive sleep apnoea in a case of thyroglossal duct cyst carcinoma

The Journal of Laryngology & Otology ◽

10.1017/s0022215112001211 ◽

2012 ◽

Vol 126 (8) ◽

pp. 864-866 ◽

Cited By ~ 2

Author(s):

A X See ◽

D Y K Chua ◽

Y M Chan ◽

C H K Goh

Keyword(s):

Lymph Node ◽

Obstructive Sleep Apnoea ◽

Sleep Apnoea ◽

Positive Lymph Node ◽

Thyroglossal Duct Cyst ◽

Diagnostic Dilemma ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Complete Surgical Excision ◽

Obstructive Sleep

AbstractObjectives:To report a rare case of thyroglossal duct cyst carcinoma which presented with obstructive sleep apnoea, and to highlight the difficulties in making this clinical diagnosis.Method:Case report and review of the English language literature concerning thyroglossal duct cyst carcinoma.Results:Thyroglossal duct cyst carcinoma is a rare clinical entity found in only approximately 1 per cent of all patients operated upon for thyroglossal duct cyst. This condition usually presents in an identical manner to its benign counterpart; atypical presentations have not previously been reported. Our patient is the first reported case of a thyroglossal duct cyst carcinoma first presenting with symptoms of obstructive sleep apnoea, without a neck mass. Complete surgical excision with total thyroidectomy and lymph node clearance was performed, in view of the positive lymph node metastases (seen on imaging) and the need for post-operative radioiodine therapy.Conclusion:Thyroglossal duct cyst carcinomas may present atypically, posing a diagnostic dilemma for the clinician. For patients diagnosed with obstructive sleep apnoea, it is imperative that a thorough otolaryngological examination be performed to exclude any underlying pathology.

Download Full-text

Midline Cervical Cleft

PEDIATRICS ◽

10.1542/peds.92.2.286 ◽

1993 ◽

Vol 92 (2) ◽

pp. 286-287

Author(s):

JOHN MADDALOZZO ◽

ANDREW FRANKEL ◽

LAUREN D. HOLINGER

Keyword(s):

Primary Care ◽

Care Physician ◽

Thyroglossal Duct Cyst ◽

Developmental Abnormality ◽

Initial Examination ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Branchial Cleft ◽

Midline Cervical Cleft ◽

Midline Cleft

The congenital midline cervical cleft represents a rare developmental abnormality that is not widely reported in the pediatric literature.1 Usually the lesion is initially evaluated by a pediatrician or other primary care physician who misinterprets the deficit as a branchial cleft deformity or thyroglossal duct cyst. Although developmentally related to these disorders, the congenital midline cleft represents a distinct anomaly that should be recognized at initial examination. The parents can then be appropriately counseled about the implications and further management decisions that are peculiar to this disorder. We have recently treated five cases of congenital midline cervical cleft at the Children's Memorial Hospital, Chicago, IL.

Download Full-text