THYROGLOSSAL DUCT CYST: AN INFREQUENTLY CONSIDERED DIAGNOSIS IN PEDIATRIC PATIENTS WITH ANTERIOR NECK MASSES

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

BMJ Case Reports ◽

10.1136/bcr-2020-236515 ◽

2020 ◽

Vol 13 (11) ◽

pp. e236515

Author(s):

Jordan Whitney Rawl ◽

Nicholas Armando Rossi ◽

Matthew G Yantis ◽

Wasyl Szeremeta

Keyword(s):

Hyoid Bone ◽

Neck Mass ◽

Thyroglossal Duct Cyst ◽

Tongue Protrusion ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Neck Masses ◽

Close Proximity ◽

Sistrunk Procedure ◽

Thyroglossal Duct Cysts

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 Causing Airway Obstruction in an Adult

Ear Nose & Throat Journal ◽

10.1177/014556139607500812 ◽

1996 ◽

Vol 75 (8) ◽

pp. 530-534 ◽

Cited By ~ 9

Author(s):

Eugene G. Brown ◽

Marcus S. Albernaz ◽

Mark T. Emery

Keyword(s):

Airway Obstruction ◽

English Language ◽

Neck Mass ◽

Thyroglossal Duct Cyst ◽

Airway Compromise ◽

Anterior Neck ◽

Duct Cyst ◽

Cervical Mass ◽

Thyroglossal Duct ◽

Thyroglossal Duct Cysts

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.

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OK-432 treatment of pediatric patients with recurrent thyroglossal duct cyst after surgery

Otolaryngologia Polska ◽

10.5604/01.3001.0014.9073 ◽

2021 ◽

Vol 75 (4) ◽

pp. 1-4

Author(s):

Nobuo Ohta ◽

Shigeru Fukase ◽

Miho Nakazumi ◽

Teruyuki Sato ◽

Takahiro Suzuki

Keyword(s):

Pediatric Patients ◽

Case Series ◽

Rare Condition ◽

Thyroglossal Duct Cyst ◽

Outpatient Basis ◽

First Line ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Total Shrinkage ◽

First Line Treatment

Introduction: Recurrent thyroglossal duct cyst after surgery is not a rare condition and first-line treatment has not been established yet. Aim: Evaluation of outcomes and complications of OK-432 treatment in patients with recurrent thyroglossal duct cyst after surgery. Material and methods: This study is designed as a case series with planned data collection at Tohoku Medical and Pharmaceutical University and Fukase Clinic. Five patients with recurrent thyroglossal duct cyst after surgery received this therapy between January 2014 and February 2020 on an outpatient basis, without hospitalization. OK-432 solution was injected into the lesion using an 18- or 27-gauge needle, depending on the location and size of the lesion, as well as on possible complications. Results: Lesions showed marked reduction or total shrinkage in all patients, with no local scarring or deformity at the injection site. Side effects manifested as local pain at the site of injection and fever (37.5–38.5°C) observed in three patients, but the symptoms resolved within a few days. Conclusions: Since OK-432 therapy is simple, easy, safe and effective, it can be used as an alternative to surgery in the treatment of recurrent thyroglossal duct cyst after surgery.

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Thyroglossal duct cyst presenting as life-threatening airway obstruction in a neonate

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1049 ◽

2021 ◽

Vol 2 (2) ◽

Author(s):

Duha Hejla ◽

◽

Erella Elkon-Tamir ◽

Li-tal Pratt ◽

Oshri Wasserzug ◽

...

Keyword(s):

Cricoid Cartilage ◽

Thyroglossal Duct Cyst ◽

Solid Mass ◽

Duct Cyst ◽

Oral Flora ◽

Thyroglossal Duct ◽

Neck Masses ◽

Life Threatening ◽

Thyroglossal Duct Cysts ◽

Prior Infection

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].

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Computed Tomography and the Thyroglossal Duct Cyst

Otolaryngology ◽

10.1177/019459988609500118 ◽

1986 ◽

Vol 95 (1) ◽

pp. 93-98 ◽

Cited By ~ 19

Author(s):

Robert F. Ward ◽

Robert W. Selfe ◽

Leslie St. Louis ◽

David Bowling

Keyword(s):

Computed Tomography ◽

Hyoid Bone ◽

Close Relation ◽

Thyroglossal Duct Cyst ◽

Duct Cyst ◽

Diagnostic Modality ◽

Thyroglossal Duct ◽

Neck Masses ◽

High Resolution Images ◽

Thyroglossal Duct Cysts

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.

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Papillary Thyroid Carcinoma Within Thyroglossal Duct Cyst

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1828 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A895-A896

Author(s):

Raghda Al Anbari ◽

Majlinda Xhikola ◽

Sushma Kadiyala

Keyword(s):

Thyroid Gland ◽

Total Thyroidectomy ◽

Thyroid Cartilage ◽

Thyroid Tissue ◽

Neck Mass ◽

Thyroglossal Duct Cyst ◽

Papillary Thyroid ◽

Anterior Neck ◽

Duct Cyst ◽

Thyroglossal Duct

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.

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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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Concurrent thyroglossal duct cyst and dermoid cyst in two pediatric patients

International Journal of Pediatric Otorhinolaryngology Extra ◽

10.1016/j.pedex.2012.10.001 ◽

2012 ◽

Vol 7 (4) ◽

pp. 196-199

Author(s):

Rui Jun Lin ◽

J. Paul Moxham ◽

Neil K. Chadha

Keyword(s):

Dermoid Cyst ◽

Pediatric Patients ◽

Thyroglossal Duct Cyst ◽

Duct Cyst ◽

Thyroglossal Duct

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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.

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