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Mylopotamitaki K, Klonaris D, Kazamias G, Simandirakis C, Vourliotaki I, Karakostas E. A Rare Case Report of Thyroglossal Duct Cyst Carcinoma Coexisting with Thyroid Carcinoma in an Adolescent. Case Rep Otolaryngol 2023; 2023:6640087. [PMID: 37705684 PMCID: PMC10497364 DOI: 10.1155/2023/6640087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/31/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023] Open
Abstract
Background Thyroglossal duct cysts (TDC) represent approximately 70% of all congenital neck masses, and up to 1% of them contain thyroid tissue malignancies. Clinical presentation of TDC carcinomas is usually indistinguishable from benign tumors preoperatively, and differential diagnosis can be challenging. We present a rare case of TDC carcinoma concurrent with thyroid cancer in an adolescent. Case Presentation. A 16-year-old Caucasian female, otherwise healthy, was referred with a painless, gradually expanding lump on the neck. Physical examination revealed a well-circumscribed, moderately hard, tender mass of the anterior neck midline anteroinferior to the hyoid bone. Imaging findings suggested TDC as the most likely diagnosis. The patient had a Sistrunk procedure under general anesthesia. Histopathological findings diagnosed a BRAFV600E-positive papillary thyroid carcinoma (PTC) in a TDC. A thyroid gland and neck ultrasound revealed a highly suspicious finding for malignancy right level VI lymph node, which was not confirmed by fine needle aspiration cytology (FNAC). Under general anesthesia, total thyroidectomy and central compartment lymph node neck dissection were performed. Histopathological findings revealed a thyroid parenchymal locus of PTC, as well as three lymph nodes infiltrated by PTC. The patient received adjuvant radioactive iodine ablation (RAI) therapy and is closely followed. Conclusion TDC carcinomas in conjunction with thyroid carcinomas in young patients are rare. Preoperative diagnosis can be challenging, as the vast majority of neck masses in young patients are benign in nature, and most malignant tumors lack specific clinical features. The diagnostic accuracy of FNAC is considered unsatisfactory due to its frequently cystic nature. Definitive diagnosis is based on histopathological findings. Clinicians should maintain a high level of suspicion for coexisting thyroid malignancies. Although surgical extirpation of the malignancy is considered standard of care, the treatment of TDC cancer should always be individualized by a multidisciplinary team.
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Affiliation(s)
- Kleanthi Mylopotamitaki
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
- University of Crete, School of Medicine, Greece
| | - Dionisios Klonaris
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
| | - Georgios Kazamias
- Department of Pathology, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
| | - Christos Simandirakis
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
| | - Irene Vourliotaki
- Department of Endocrinology, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
| | - Efthimios Karakostas
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
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Rovira A, Brunet A, Jeannon JP, Carroll PV, Touska P, Hassan F, Sandison A, Simo R. Thyroglossal duct cyst carcinoma case series-Management strategy and outcomes. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2023; 74:203-210. [PMID: 37479461 DOI: 10.1016/j.otoeng.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/04/2022] [Indexed: 07/23/2023]
Abstract
OBJECTIVE To review the clinical presentation, diagnosis, pathology and management strategies in a modern cohort of patients with thyroglossal duct cyst carcinoma. STUDY DESIGN Retrospective case series following PROCESS Guidelines. SETTING Comprehensive cancer centre. METHODS Data recorded included: gender, age at diagnosis, clinical presentation, thyroid function, diagnostic investigations, cytological results, final histology, staging and follow up status. The risk of malignancy in cytological analysis was stratified according to the Royal College of Pathologists classification in United Kingdom. RESULTS Twelve patients were included. The majority of patients (66.7%) presented with an isolated thyroglossal duct cyst. Only 4 patients had preoperative cytological suspicion of carcinoma (sensitivity: 33.3%). At the time of presentation all patients were euthyroid. Following diagnosis of malignancy, a total thyroidectomy was performed in all patients, with the exception of 2, who had a thyroglossal duct cyst carcinoma of less than 10mm. Among the 10 patients who underwent total thyroidectomy, 7 (70%) patients had proven carcinoma in the thyroid gland, 3 with deposits of less than 10mm. The average size of the thyroid cancer deposits was 7.2mm (1-20mm). With a mean follow-up of is 44 months (5-120), all patients were alive and free of recurrence at the end of the study period. CONCLUSION Thyroglossal duct cyst carcinoma is a rare condition and its management should be discussed in a multidisciplinary meeting. As with differentiated thyroid cancer originating in the thyroid gland, it bears extraordinary survival rates. Accordingly, the management of these cancers has shifted towards a more conservative approach although its peculiarities must be taken into account: ease of extracystic invasion and possible different lymph node invasion.
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Affiliation(s)
- Aleix Rovira
- Department of Otorhinolaryngology Head & Neck Surgery, Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom.
| | - Aina Brunet
- Department of Otorhinolaryngology Head & Neck Surgery, Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Jean Pierre Jeannon
- Department of Otorhinolaryngology Head & Neck Surgery, Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Paul V Carroll
- Department of Endocrinology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Phil Touska
- Department of Radiology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Fahim Hassan
- Department of Nuclear Medicine, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Ann Sandison
- Department of Histopathology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Ricard Simo
- Department of Otorhinolaryngology Head & Neck Surgery, Head, Neck and Thyroid Oncology Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom
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3
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Suresh S, VM P, Thomas S, Patil S, George NA, Janardhan D, Iype EM, Varghese BT, Mathew A, JV A. Papillary Thyroid Carcinoma Arising from Thyroglossal Cyst-an Institutional Experience over a Decade. Indian J Surg Oncol 2023; 14:155-159. [PMID: 36891423 PMCID: PMC9986360 DOI: 10.1007/s13193-022-01628-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/18/2022] [Indexed: 10/14/2022] Open
Abstract
Papillary carcinoma constitutes 80% of thyroglossal duct cyst carcinoma (TGCC). The mainstay of treatment for TGCC is Sistrunk procedure. Due to lack of clear-cut guidelines in managing TGCC, the role of total thyroidectomy, neck dissection and adjuvant radioiodine therapy is still debatable. This was a retrospective study which included cases of TGCC treated in our institution over a period of 11 years. The aim of study was to assess the need for total thyroidectomy in management of TGCC. Patients were divided into two groups based on the surgical treatment they underwent and the treatment outcomes were compared. The histology was papillary carcinoma in all cases of TGCC. Overall, 43.3% of TGCCs had a focus of papillary carcinoma in total thyroidectomy specimen. Lymph node metastasis was noted only in 10% of TGCC and not identified in isolated papillary carcinoma confined to thyroglossal cyst. 7-year overall survival (OS) for TGCC was 83.1%. Prognostic factors like extracapsular extension or lymph node metastasis did not affect OS. Addition of total thyroidectomy and neck dissection to Sistrunk procedure did not offer any survival advantage. In a case of TGCC, FNAC should be done from any clinically suspicious thyroid nodules or lymph nodes. TGCC has a good prognosis following treatment and none of the cases in our series has disease recurrence during follow-up. Sistrunk procedure was an adequate procedure for treatment of TGCC with clinically and radiologically normal thyroid gland.
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Affiliation(s)
- Sandeep Suresh
- Department of Head & Neck Surgery, Regional Cancer Centre, Thiruvananthapuram, India
| | - Pradeep VM
- Department of Nuclear Medicine, Regional Cancer Centre, Thiruvananthapuram, India
| | - Shaji Thomas
- Department of Head & Neck Surgery, Regional Cancer Centre, Thiruvananthapuram, India
| | - Shirish Patil
- Department of Head & Neck Surgery, Regional Cancer Centre, Thiruvananthapuram, India
| | - Nebu Abraham George
- Department of Head & Neck Surgery, Regional Cancer Centre, Thiruvananthapuram, India
| | - Deepak Janardhan
- Department of Head & Neck Surgery, Regional Cancer Centre, Thiruvananthapuram, India
| | - Elizabeth Mathew Iype
- Department of Head & Neck Surgery, Regional Cancer Centre, Thiruvananthapuram, India
| | - Bipin T. Varghese
- Department of Head & Neck Surgery, Regional Cancer Centre, Thiruvananthapuram, India
| | - Aleyamma Mathew
- Department of Biostatistics and Epidemiology, Regional Cancer Centre, Thiruvananthapuram, India
| | - Ammu JV
- Department of Biostatistics and Epidemiology, Regional Cancer Centre, Thiruvananthapuram, India
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4
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Rovira A, Brunet A, Jeannon JP, Carroll PV, Touska P, Hassan F, Sandison A, Simo R. Thyroglossal duct cyst carcinoma case series—Management strategy and outcomes. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022. [DOI: 10.1016/j.otorri.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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5
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Roh JL. Removal of Thyroglossal Duct Cyst by a Submental Approach. World J Surg 2022; 46:1431-1437. [PMID: 35195754 DOI: 10.1007/s00268-022-06493-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Thyroglossal duct cyst (TGDC) is the most common congenital cyst in the neck and is removed by the Sistrunk procedure. This surgery involves a horizontal skin incision over the cyst that may leave a noticeable scar on the front of the neck. Therefore, this study examined the clinical outcomes and cosmetic benefits of the Sistrunk procedure by an incision in the submental area that is not easily visible from the front. MATERIALS AND METHODS This observational study was performed on 152 patients who underwent the Sistrunk procedure by a submental approach to remove TGDC at a university medical center. Intraoperative findings, postoperative complications, subjective pain levels, and satisfaction with incision scars and neck and facial deformities, and recurrence were prospectively evaluated. RESULTS The length of the submental incision was about 3 cm and the median total operation time was 36 min. Postoperative complications were minimal. Hematoma occurred in two cases (1.3%), surgical site infection in 1 case (0.7%), and dysphagia for more than 1 week occurred in 1 case (0.7%). On a 0-10 visual analogue scale, the pain had a median value of 2 on the first day after surgery, and satisfaction with incision scars and neck and facial deformities showed median values of 8 and 10 at 6 months after surgery, respectively. Recurrence occurred in one patient (0.7%) during the median follow-up period of 68 months. CONCLUSIONS The submental approach for TGDC excision may be a reliable new surgical method that is safe and has cosmetic advantages. This observational study evaluated the clinical outcomes and cosmetic benefits of the Sistrunk procedure by a submental incision for thyroglossal duct cyst in 152 patients. The surgical procedure showed no increased operation time, no need for wide flap elevation, easy suprahyoid dissection, and an invisible scar in a natural position of the neck.
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Affiliation(s)
- Jong-Lyel Roh
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, 13496, Republic of Korea.
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Gómez-Álvarez LR, Treviño-Lozano MA, de la O-Escamilla ME, Vergara-Miranda H, Anda LAMD, Falcón LÁC, Tafoya AR. Papillary thyroid carcinoma from a thyroglossal cyst: case series. J Surg Case Rep 2022; 2022:rjab613. [PMID: 35178241 PMCID: PMC8846928 DOI: 10.1093/jscr/rjab613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/17/2021] [Indexed: 11/14/2022] Open
Abstract
Papillary carcinoma originating from a thyroglossal cyst represents an infrequent finding, which occurs in ~1% of cases of thyroglossal cyst and its presentation is usually the same as that of a benign cyst, which represents the most frequent benign congenital lesion of the neck. The diagnosis is usually presented as a finding on the histopathological examination. Two cases of a thyroglossal cyst with later development of malignancy are presented. The first, a 30-year-old female, and the second, a 32-year-old male. Both began their condition after presenting an increase in volume in the neck, the female presented a right sub-mental triangle of 1 year of evolution, and the male on the anterior side of the neck. In both cases, the diagnosis of thyroglossal cyst was made by the physical examination and findings of cervical ultrasound and computed axial tomography. Surgical management consisted of the Sistrunk procedure with a definitive histopathological result for papillary thyroid carcinoma originating from thyroglossal cyst. In the case of the male patient, the Sistrunk procedure was performed along a total thyroidectomy, although in the female patient, a total thyroidectomy was performed in a second stage. Patients were then discharged and referred to the endocrinology service for further medical treatment. The management of these cases continues to be controversial due to the limited number of reported cases, so the multidisciplinary management and individualization of each case plays a fundamental role in the management of this rare condition.
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Affiliation(s)
| | | | | | - Héctor Vergara-Miranda
- Department of General Surgery, Oncology Surgery, Institution, Monterrey, Nuevo León, México
| | | | | | - Ary Rochio Tafoya
- Department of General Surgery, Oncology Surgery, Institution, Monterrey, Nuevo León, México
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Coexisting Thyroglossal Duct Cyst with Papillary Thyroid Cancer: A Case Report and Literature Review. Case Rep Otolaryngol 2022; 2021:6111308. [PMID: 34987876 PMCID: PMC8720604 DOI: 10.1155/2021/6111308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/16/2021] [Indexed: 11/18/2022] Open
Abstract
Thyroglossal duct cysts (TGDCs) are common developmental anomalies in which the thyroglossal duct is not obliterated. Coexisting papillary thyroid cancer and TGDC are uncommon and should be investigated thoroughly to rule out TGDC carcinoma. We report a rare case of coexisting papillary thyroid cancer and TGDC in a 48-year-old man, who presented with a history of recurrent mild painful midline neck swelling, and ultrasound (US) revealed a TGDC that was subsequently managed conservatively. On follow-up after 1.6 years, a thyroid US and a fine-needle aspiration (FNA) biopsy were performed, which showed malignant papillary thyroid carcinoma. Total thyroidectomy, the Sistrunk procedure, and central neck dissection were implemented. After three days, the patient was discharged on 150 mg of levothyroxine. Follow-up was unremarkable with no complications. The authors would like to stress the importance of regular TGDC and thyroid gland follow-ups for early detection and diagnosis of thyroid malignancy via clinical examination and US.
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8
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Chandraratnam E, Luo J, Wong E. Intra-Thyroid Thyroglossal Duct Cyst Incidentally Identified in an Adult With Primary Hyperparathyroidism: A Rare Case Report and Literature Review. Cureus 2021; 13:e20399. [PMID: 35036228 PMCID: PMC8754355 DOI: 10.7759/cureus.20399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/05/2022] Open
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9
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Wong J, Lee JC, Grodski S, Yeung M, Serpell J. Cancer in thyroglossal duct cysts. ANZ J Surg 2021; 92:443-447. [PMID: 34791748 DOI: 10.1111/ans.17369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/21/2021] [Accepted: 10/29/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Thyroglossal duct cysts (TDC) account for 7% of midline neck swellings. TDC carcinoma (TDCC) is rare, reported in 1% of all TDCs. We aimed to describe the incidence of TDCC, the accuracy of fine needle aspiration cytology (FNAC), and to identify suspicious, predictive ultrasound (USG) features. METHOD A cross sectional study of TDC patients in the Monash University Endocrine Surgery Database from 2001 to 2021. RESULTS Eighty-six patients had surgery for TDC, of median age 48 and a female preponderance (62%). Preoperative USG was used in 85% and FNAC in 57%. There were six cases (7%) of TDCC with papillary thyroid cancer (PTC). USG in five TDCC cases showed a solid nodule within the cyst wall. FNAC was undertaken in five TDCC cases from the solid nodule; malignant in one and suspicious for malignancy in two. Two TDCC patients had concurrent total thyroidectomy (TT), and three subsequently had a TT. Multifocal thyroid PTC was found in two patients. One patient had a recurrence in the lateral lymph nodes, nine years after excision of the TDCC and TT. All patients are alive and well with no distant metastases (median follow up 11 years). CONCLUSION The 7% incidence of TDCC is higher than the usually reported 1% in the literature. We recommend a preoperative USG to evaluate the TDC, thyroid gland and cervical lymph nodes, and an FNAC to target the solid component of the TDC, and favour total thyroidectomy for all patients with TDCC.
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Affiliation(s)
- Jessica Wong
- Monash University Endocrine Surgery Unit, Alfred Health, Melbourne, Victoria, Australia
| | - James C Lee
- Monash University Endocrine Surgery Unit, Alfred Health, Melbourne, Victoria, Australia.,Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Simon Grodski
- Monash University Endocrine Surgery Unit, Alfred Health, Melbourne, Victoria, Australia
| | - Meei Yeung
- Monash University Endocrine Surgery Unit, Alfred Health, Melbourne, Victoria, Australia
| | - Jonathan Serpell
- Monash University Endocrine Surgery Unit, Alfred Health, Melbourne, Victoria, Australia
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Hou T, Liu Z, Gan Q, Debnam JM, Krishnamurthy S. Clinical and cytopathological features of suspected thyroglossal duct cysts and neoplasms arising from them: A large series from a referral cancer center. Cancer Cytopathol 2021; 130:72-79. [PMID: 34529338 DOI: 10.1002/cncy.22511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Thyroglossal duct cysts (TGDCs) are the most common congenital midline cystic lesions in the neck, and they are often evaluated by fine-needle aspiration. Recognizing the cytomorphologic features of TGDCs and their mimics is important for clinical management. METHODS This study examined the clinical, radiological, and cytopathological features of 86 ultrasonography-guided fine-needle aspiration (US-FNA) specimens from clinically suspected TGDCs or malignancies arising from TGDCs and correlated the findings with surgical follow-up and/or imaging studies. RESULTS According to ultrasound examinations of 66 lesions, 17 (25.8%) were cystic, 8 (12.1%) were cystic with septations, 21 (31.8%) were cystic with solid nodules, and 20 (30.3%) were solid or cystic with internal debris. Cytopathologically, 81 lesions (94%) were categorized as benign, 2 (2%) were categorized as atypical, and 3 (3%) were categorized as malignant. In benign lesions, proteinaceous material (63%), histiocytes (63%), colloid (37%), squamous cells (35%), columnar cells (32%), follicular cells (15%), inflammatory cells (9%), and multinucleated giant cells (9%) were noted. Diagnoses in the benign category included TGDC in 64 patients (75%), TGDC or mimics (colloid nodule/epidermoid cyst) in 14 patients (17%), a colloid nodule in 1 patient, and thyroiditis in 1 patient. Surgical resection, performed in 23 patients, confirmed TGDCs in 12, benign mimics in 7, and carcinoma in 4. CONCLUSIONS Cytopathological features, in conjunction with imaging, allowed a definite diagnosis of TGDC in most patients (75%). The presence of mature squamous cells, thyroid follicular cells, with or without colloid and/or lymphocytes alone allowed a differential diagnosis of TGDC and its mimics in 17%. US-FNA findings could not distinguish primary carcinomas arising from TGDCs from metastatic tumors.
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Affiliation(s)
- Tieying Hou
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zhonghua Liu
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Qiong Gan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - J Matthew Debnam
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Savitri Krishnamurthy
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Lancini D, Lombardi D, Piazza C. Evidence and controversies in management of thyroglossal duct cyst carcinoma. Curr Opin Otolaryngol Head Neck Surg 2021; 29:113-119. [PMID: 33664197 PMCID: PMC9928562 DOI: 10.1097/moo.0000000000000699] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW The aim of this study was to analyse the rational of the possible therapeutic approaches to thyroglossal duct cyst carcinomas (TGDCCa), especially in consideration of their potential airway involvement, discussing the most debated issues concerning employment of thyroidectomy, neck dissection and adjuvant treatments. RECENT FINDINGS The literature is unanimous in defining the Sistrunk procedure as the baseline of surgical treatment of TGDCCa, and in equating the vast majority of thyroid-like TGDCCas to classic thyroid cancers from a biological point of view, while the rarer squamous cell carcinomas seem to behave more aggressively. Thyroidectomy, neck dissection and radioactive iodine treatment are considered for high-risk lesions, with the addition of customized partial resection of laryngeal cartilages when airway involvement is encountered. Furthermore, the analysis of thyroid mutational markers has promise for accurate prevision of more aggressive clinical behaviours. SUMMARY Even if rare, clinicians should be aware of TGDCCa due to the possibility of incidental diagnosis and, in the case of more advanced clinical scenarios, for its potential airway involvement. Sistrunk procedure combined with thyroidectomy, neck dissection and adjuvant therapy provide excellent results in high-risk patients. Additional study of pathological thyroid markers in TGDCCa is desirable to allow more individualized treatments.
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Affiliation(s)
- Davide Lancini
- Department of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia
| | - Davide Lombardi
- Department of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia
| | - Cesare Piazza
- Department of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
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12
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Koempel JA, Brooks J, Snow MH, Osterbauer B, Garcia E, Bawab R, Shows J, Parham D. The Relevance of and Surgical Approach to the Suprahyoid Region in Thyroglossal Duct Surgery. Laryngoscope 2020; 131:553-558. [PMID: 32668033 DOI: 10.1002/lary.28887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Persistent or recurrent disease following excision of a thyroglossal duct cyst/sinus (TGDC) is often found in the suprahyoid region. Cadaver dissections were performed to identify and name important surgical landmarks in the suprahyoid area; a histopathologic analysis of surgical specimens was completed to determine the incidence and extent of microscopic disease; and clinical outcomes were compared to determine the efficacy of a specific anatomic dissection. STUDY DESIGN Retrospective case series. METHODS Standardized dissections of four adult cadavers were performed. Consecutive surgical specimens were examined for evidence of microscopic TDGC disease in the suprahyoid region, measuring the greatest width and length of disease. A retrospective review of all consecutive TGDC procedures was completed. RESULTS The important surgical landmarks in the suprahyoid area were identified in all cadavers. Microscopic disease in the suprahyoid area was found in 79% (37 of 47) of surgical specimens. The mean greatest length and width of microscopic disease was 12.4 mm and 1.4 mm, respectively. Following identification of these landmarks, the incidence of recurrent or persistent disease decreased (P = .02) from 5% (8 of 159) to 0% (0 of 112). CONCLUSION The majority of pediatric patients with a TGDC will have microscopic disease in the suprahyoid area. The surgical landmark of the fascial plane between the geniohyoid and genioglossus muscles demarcates the anterior and lateral borders of resection in the suprahyoid area. This approach can be used as a reliable and easily reproducible technique in TGDC surgery to increase confidence of achieving complete removal of disease in the suprahyoid area, avoiding persistent or recurrent disease and a revision procedure. LEVEL OF EVIDENCE 4 Laryngoscope, 131:553-558, 2021.
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Affiliation(s)
- Jeffrey A Koempel
- Division of Otolaryngology - Head and Neck Surgery, Children's Hospital Los Angeles, Los Angeles, California, U.S.A
| | - Jennifer Brooks
- Department of Otolaryngology & Communication Enhancement, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Mikel H Snow
- Department of Cell and Neurobiology, Keck School of Medicine of the University of Southern California, Los Angeles, California, U.S.A
| | - Beth Osterbauer
- Division of Otolaryngology - Head and Neck Surgery, Children's Hospital Los Angeles, Los Angeles, California, U.S.A
| | - Erick Garcia
- Keck School of Medicine of the University of Southern California, Los Angeles, California, U.S.A
| | - Ramzi Bawab
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, U.S.A
| | - Jared Shows
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, U.S.A
| | - David Parham
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, U.S.A
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13
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Park MJ, Shin HS, Choi DS, Choi HY, Choi HC, Lee SM, Jang JH, Lee JH, Park JJ, Park SE. A rare case of thyroglossal duct cyst extending to the sublingual space: A case report. Medicine (Baltimore) 2020; 99:e19389. [PMID: 32332596 PMCID: PMC7220724 DOI: 10.1097/md.0000000000019389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Thyroglossal duct cyst (TGDC) is the most common congenital anomaly of midline neck masses. A thyroglossal duct cyst is especially difficult to diagnose and is treated differently when it appears in the sublingual area. Here, we report a rare case of TGDC extending to the sublingual space. PATIENT CONCERNS A 42-year-old female presented with a history of neck swelling in the submental region. DIAGNOSIS The final pathologic diagnosis was a TGDC. INTERVENTIONS Sistrunk operation was performed. OUTCOMES Recurrence of the disease has not been seen for the past year. LESSION Clinical awareness of the thyroglossal duct cyst in the sublingual area or on the oral floor area is important for an accurate diagnosis and the appropriated management.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jung Je Park
- Department of Otolaryngology, Head and Neck Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Sung Eun Park
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
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14
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Ogunkeyede SA, Ogundoyin OO. Management outcome of thyroglossal cyst in a tertiary health center in Southwest Nigeria. Pan Afr Med J 2020; 34:154. [PMID: 32110270 PMCID: PMC7024141 DOI: 10.11604/pamj.2019.34.154.18765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/23/2019] [Indexed: 11/11/2022] Open
Abstract
Thyroglossal duct cyst is a non-odontogenic congenital developmental cyst. It is predominantly a midline anterior neck swelling in children and total excision of the tracts prevents recurrence. Retrospective hospital record analysis of patients managed with histopathology results of thyroglossal cyst between 2003 and 2018. Comparing outcomes and technique of thyroglossal cyst excision in a resource challenged environment. A total of 37 patients comprising 22(59.5%) males and 15(40.5%) females (M:F 1.4:1) with age range of 13 days to 55 years (median 6 years) were managed. The majority were children less than 10 years of age. They all presented with a fluctuant midline progressive anterior neck swelling, in addition to anterior neck ulcer 1(2.7%), discharging sinuses 3(8.1%) and thyroglossal cyst duct infections, which were managed successfully with antibiotics. Central compartment neck dissection with excision of mid-portion of the hyoid bone was performed in all the patients. Rupture of thyroglossal duct cysts was observed in 7(18.9%) at surgery, but there was no recurrence. Surgical drain was not used and most patients were discharged within 48 hours postoperatively. Thyroglossal duct cyst was confirmed at histology without any evidence of mitotic changes. There was no recurrence for the Sistrunk's procedure in all specialties. The modification of the Sistrunk's procedure with mid-anterior neck dissection is effective in excising a thyroglossal duct cyst, hence preventing recurrence. Non-usage of wound drains and short hospital stay are cost effective.
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Affiliation(s)
- Segun Ayodeji Ogunkeyede
- Department of Otorhinolaryngology, College of Medicine, University of Ibadan, Ibadan, Nigeria.,University College Hospital, Ibadan, Nigeria
| | - Olakayode Olaolu Ogundoyin
- University College Hospital, Ibadan, Nigeria.,Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
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15
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Kartini D, Panigoro SS, Harahap AS. Sistrunk Procedure on Malignant Thyroglossal Duct Cyst. Case Rep Oncol Med 2020; 2020:6985746. [PMID: 32395358 PMCID: PMC7201451 DOI: 10.1155/2020/6985746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/16/2019] [Accepted: 01/06/2020] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- Diani Kartini
- Oncology Division, Department of Surgery, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Sonar S. Panigoro
- Oncology Division, Department of Surgery, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Agnes S. Harahap
- Department of Anatomical Pathology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Lee YJ, Kim DW, Shin GW, Park JY, Choo HJ, Park HK, Ha TK, Kim DH, Jung SJ, Park JS, Moon SH, Ahn KJ, Baek HJ. Comparison of Prevalence and Ultrasonography Features of Thyroglossal Duct Cyst in Adults According to Radioactive Iodine Ablation. Med Sci Monit 2019; 25:9538-9546. [PMID: 31837133 PMCID: PMC6929556 DOI: 10.12659/msm.919324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the prevalence of thyroglossal duct cysts (TGDCs) on ultrasonography (US) and US features of TGDCs in adults, and to assess whether the prevalence or size of TGDCs increases after radioactive iodine ablation (RIA). MATERIAL AND METHODS Between July and December 2018, 2820 patients underwent thyroid or neck US examination, performed by 2 radiologists, at our center. On the basis of real-time US, the presence or absence of TGDCs was prospectively investigated by 2 radiologists. Among the 2820 patients, 54 patients who were <19 years of age or had a radiation therapy history to the neck were excluded. Eventually, 2766 patients were included. RESULTS Of the 2766 patients, 160 (5.8%) showed a TGDC on US. The mean size of TGDCs in RIA history (+) (n=36) and RIA history (-) (n=124) groups was 0.92±0.41 cm and 0.86±0.45 cm, respectively. There was no significant difference in size of TGDCs between RIA history (+) and RIA history (-) groups (p=0.684). Between the TGDC (+) and TGDC (-) groups, there was no significant difference in patient age, gender, reason for thyroid/neck US, type of thyroid surgery, and session number and application/no application of RIA (p>0.05). The prevalence rate of TGDCs in radiologist A and B was 4.9% (70/1427) and 6.7% (90/1339), respectively. TGDCs were more common in the suprahyoid neck, and the common shapes of TGDCs were flat-to-ovoid and round. CONCLUSIONS RIA may not be associated with the prevalence or enlargement of TGDCs.
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Affiliation(s)
- Yoo Jin Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Dong Wook Kim
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Gi Won Shin
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Jin Young Park
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Hye Jung Choo
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Ha Kyoung Park
- Department of General Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Tae Kwun Ha
- Department of General Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Do Hun Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Soo Jin Jung
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Ji Sun Park
- Department of Nuclear Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Sung Ho Moon
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Ki Jung Ahn
- Department of Radiation Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Hye Jin Baek
- Department of Radiology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, South Korea
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Tynan T, Potter N. Intra-hyoid thyroglossal duct cyst: embryology in practice. ANZ J Surg 2019; 90:1506-1507. [PMID: 31782224 DOI: 10.1111/ans.15594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/30/2019] [Accepted: 11/03/2019] [Indexed: 11/30/2022]
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BRAF V600E mutation: a potential predictor of more than a Sistrunk's procedure in patients with thyroglossal duct cyst carcinoma and a normal thyroid gland. Updates Surg 2019; 71:701-704. [PMID: 31586312 DOI: 10.1007/s13304-019-00684-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 09/30/2019] [Indexed: 01/15/2023]
Abstract
To assess the utility of mutational markers in determining the most appropriate initial surgery for patients with thyroglossal duct cyst carcinoma (TGDCCa) and a normal thyroid gland. Our sample comprised 15 patients with a diagnosis of TGDCCa and a thyroid gland histologically negative for any malignant involvement, who underwent surgery between the years 1994 and 2017. Clinical records were reviewed and tissue specimens were genetically tested for the presence of the most commonly encountered mutational markers in differentiated thyroid cancer: BRAF, N-RAS, and H-RAS. The primary outcome of interest was the correlation between mutational marker positivity and the T-stage of the primary tumor and its potential implication on therapeutic decision making. All 15 cases were papillary carcinomas with a mean tumor size of 17 mm (2-40 mm). According to the 7th edition of the American Joint Committee on Cancer TNM staging system, these represented: T1 (n = 3), T2 (n = 1), and T3 (n = 11). Cancerous invasion of the pericystic soft tissue and/or hyoid bone was considered T3. BRAFV600E was the only mutational marker identified (7 in 15 cases). All BRAFV600E-positive lesions were T3, necessitating radioactive iodine ablation (RIA) therapy, therefore, total thyroidectomy. The correlation between BRAFV600E positivity and extracystic cancerous extension was statistically significant [1.0 (7/7) vs. 0.5 (4/8); p value = 0.0035]. BRAFV600E positivity seems to be predictive of locally advanced disease mandating RIA therapy. Therefore, it could serve as a preoperative tool that predicts the need for total thyroidectomy, in addition to Sistrunk's procedure.
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Isaacson G, Kaplon A, Tint D. Why Central Neck Dissection Works (and Fails) for Recurrent Thyroglossal Duct Remnants. Ann Otol Rhinol Laryngol 2019; 128:1041-1047. [PMID: 31271039 DOI: 10.1177/0003489419859033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To review the patient characteristics and outcomes for children and undergoing central neck dissection for control of recurrent thyroglossal duct cysts and fistula following prior Sistrunk procedures and children requiring surgery for refractory infection. METHODS We performed a computerized review of all children who were evaluated for thyroglossal duct cysts during the years 1999-2018 by a single surgeon operating at an urban children's hospital and an outpatient surgical center. Those requiring a central neck dissection for control of recurrent disease or intractable infection were identified. Age at time of surgery, sex, surgical procedure, and postoperative complications were recorded. These data were combined with similar data from a published report by the same surgeon in the years 1990-1998 to complete a 28-year review. RESULTS 18 central neck dissections were performed including 13 for recurrent thyroglossal duct remnants after Sistrunk procedures and 5 primary surgeries for intractable infection. Ages ranged from 3 to 19 years (median = 10 years) and 13 of 18 were girls (72%). Four children had their first Sistrunk surgery performed by the senior author. Three children operated elsewhere had intact hyoid bones at the time of revision surgery, suggesting less-than-Sistrunk primary surgeries. Central neck dissection controlled disease in the lower neck in all cases. One child re-fistulized at the level of the hyoid. CONCLUSIONS Central neck dissection in combination with a Sistrunk-type dissection of the tongue base is effective in the control of recurrent infection following unsuccessful Sistrunk surgery and aids in dissection for children with intractable infection. Although this technique reliably controls infrahyoid disease and improves access to the hyoid and posterior hyoid space, it does nothing to address the difficulties of following the thyroglossal tract into the tongue base.
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Affiliation(s)
- Glenn Isaacson
- Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.,Department of Pediatrics, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Adam Kaplon
- Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Derrick Tint
- Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.,Pittsburgh Ear Associates, PA, USA
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20
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Infected Lingual Thyroglossal Duct Cyst Mimicking Supraglottitis. J Craniofac Surg 2019; 30:e380-e382. [PMID: 30882577 DOI: 10.1097/scs.0000000000005427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
A thyroglossal duct cyst (TGDC) is a common embryological remnant that typically presents as an anterior neck mass; however, this malformation can occur in any adjacent area, including the tongue base (lingual type), along the migration path of the thyroid during embryonic development. Lingual TGDC is often quiescent until infection occurs. Supraglottitis or inflammation of the supraglottis, is a potentially life-threatening disease. Because of the anatomical proximity of lingual TGDC to the supraglottis, lingual TGDC infection might be related to a presentation of supraglottitis. A 49-year-old male initially presented with clinical symptoms of acute supraglottitis. After intensive medical treatment resulting in no improvement, a computed tomography scan was performed. The result raised the suspicion of an infected lingual TGDC. Transoral marsupialization using a rigid laryngoscope was performed to drain the abscess inside the cyst. A diagnosis of lingual TGDC was made based on the characteristic histological pattern of the lesion. After treatment, a follow-up computed tomography scan showed no evidence of recurrence. To the authors' knowledge, only a few reports have pointed out similarities in the clinical and radiological findings between acute supraglottitis and an infected lingual TGDC. Clinicians should consider lingual TGDC during the differential diagnosis of supraglottitis, especially in patients with poor response to medical treatment.
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21
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Anderson JL, Vu K, Haidar YM, Kuan EC, Tjoa T. Risks and complications of thyroglossal duct cyst removal. Laryngoscope 2019; 130:381-384. [PMID: 30865298 DOI: 10.1002/lary.27918] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 01/21/2019] [Accepted: 02/19/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVES/HYPOTHESIS Thyroglossal duct cysts (TGDCs) are the most common congenital neck cyst and typically present in childhood or adolescence, although a subset remains asymptomatic until adulthood. Although treatment involves surgical excision, few large-scale studies exist regarding the risks of surgical treatment of TGDCs in adults. This study aims to describe the characteristics of adult patients undergoing TGDC excision and to analyze risk factors associated with reoperation or other postoperative complications. STUDY DESIGN Retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. METHODS Patients age ≥ 18 years in the NSQIP database who underwent TGDC removal from 2005 to 2014 were included. Covariates included patient demographics, comorbidities, preoperative variables, and intraoperative variables. Outcomes included reoperation, complications, and length of hospital stay. RESULTS A total of 793 cases met inclusion criteria. Patients were predominantly female (57.0%) and white (64.3%), with a mean age of 44.3 years. Thirty-day mortality did not occur in this cohort, but 3.0% of patients experienced at least one complication. Forty-eight patients (6.1%) underwent reoperation. Wound infection rates were higher in revision operations compared with primary operations (8.3% and 0.9%, respectively; P = .003). Low preoperative sodium was associated with reoperation (P = .047). Additionally, length of hospital stay was associated with increased total operative time (P = .02). CONCLUSIONS TGDC excision is a safe and well-tolerated procedure in the adult population, with low complication rates. However, the risk of reoperation, surgical-site infections, and medical complications should be taken into consideration during preoperative planning. LEVEL OF EVIDENCE NA Laryngoscope, 130:381-384, 2020.
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Affiliation(s)
- Jennifer L Anderson
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California.,and the Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Kimberly Vu
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California
| | - Yarah M Haidar
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California
| | - Tjoson Tjoa
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California
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22
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Keelawat S, Bychkov A. Compact buds with biphasic differentiation and calcitonin-expressing neuroendocrine cells—previously unrecognized structures of thyroglossal duct unveiled by immunohistochemistry. Virchows Arch 2019; 474:609-617. [DOI: 10.1007/s00428-019-02536-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 01/28/2019] [Indexed: 12/19/2022]
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23
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Kim SC, Sun HY, Kim HS, Ryoo I. Long-Term Ultrasound Follow-Up of Incidentally Detected Thyroglossal Duct Cysts in Adults. AJNR Am J Neuroradiol 2018; 39:2356-2359. [PMID: 30467213 DOI: 10.3174/ajnr.a5882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 09/29/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE There has been no previous study that used ultrasonography for longitudinal changes of thyroglossal duct cysts, to our knowledge. We assessed the prevalence and interval changes in incidentally detected thyroglossal duct cysts in adults. MATERIALS AND METHODS From January 2010 to December 2016, we identified 796 ultrasonography radiologic reports from 513 subjects that contained the words "thyroglossal" or "TGDC" among 54,369 participants. Of 513 subjects, 172 (M/F = 103:69, mean age, 53 ± 11 years) who underwent ≥2 sonography studies were enrolled. Two reviewers determined ultrasonography features, including maximal diameter, location, internal echogenicity, wall thickness, and the presence of posterior enhancement, internal septa, and solid components. RESULTS The mean follow-up time of total 172 lesions was 2.01 ± 1.13 years. Thyroglossal duct cysts ranged from 2 to 32 mm (mean, 8.77 ± 3.83 mm) on the initial ultrasonography examination. On follow-up ultrasonography studies, 14 lesions (8.2%) increased by >2 mm, while most thyroglossal duct cysts (133 lesions, 77.3%) remained stable in size. During the follow-up period, 31 lesions (18.0%) showed interval changes in ultrasonography features. There was no significant relationship between the presence of ultrasonography feature changes and size changes (P = .12). CONCLUSIONS On ultrasonography, 0.9% of adults had incidental thyroglossal duct cysts. Most did not increase in size with time despite changes in various ultrasonography features. Therefore, we recommend performing an observation at long intervals of 2-3 years for asymptomatic thyroglossal duct cysts, and we suggest that fine-needle aspiration can be suspended unless suspicious findings of malignancy are detected.
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Affiliation(s)
- S C Kim
- From the Department of Radiology (S.C.K., H.Y.S., H.S.K.), Seoul National University Hospital Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, South Korea
| | - H Y Sun
- From the Department of Radiology (S.C.K., H.Y.S., H.S.K.), Seoul National University Hospital Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, South Korea
| | - H S Kim
- From the Department of Radiology (S.C.K., H.Y.S., H.S.K.), Seoul National University Hospital Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, South Korea
| | - I Ryoo
- From the Department of Radiology (S.C.K., H.Y.S., H.S.K.), Seoul National University Hospital Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, South Korea
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Ballivet de Régloix S, Maurin O, Crambert A, Genestier L, Bonfort G, Pons Y. [Congenital cysts and fistulas on the neck in adults]. Presse Med 2018; 48:29-33. [PMID: 30391270 DOI: 10.1016/j.lpm.2018.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/12/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022] Open
Abstract
Cervical congenital malformations are relatively common in children. They can also be found in adults. The embryological development of the cervical region is closely related to the branchial clefts. This must be a diagnosis made by elimination; a cervical tumor must evoke the diagnosis of cancer. A cutaneous fistula or a cervical tumor, chronic or recent appearance in an inflammatory context, are the clinical signs. The thyroglossal duct cysts and the second branchial clefts cysts are the most common causes of median and lateral cervical cysts, respectively. Imaging contributes greatly to the orientation and diagnostic evaluation of the extent of the lesions. Treatment is initially based on antibiotic therapy and then on complete surgical excision, away from an infectious episode, the sole guarantee for the absence of local recurrence.
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Affiliation(s)
- Stanislas Ballivet de Régloix
- Hôpital d'instruction des Armées-Percy, service d'ORL et de chirurgie cervico-faciale, 101, avenue Henri-Barbusse, 92140 Clamart, France.
| | - Olga Maurin
- Brigade des Sapeurs-Pompiers de Paris, Antenne médicale 3(e) groupement, 12, rue Henri-Regnault, 92400 Courbevoie, France
| | - Anna Crambert
- Hôpital d'instruction des Armées-Percy, service d'ORL et de chirurgie cervico-faciale, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - Louise Genestier
- Hôpital d'instruction des Armées-Percy, service d'ORL et de chirurgie cervico-faciale, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - Gratien Bonfort
- Hôpital d'instruction des Armées-Percy, service d'ORL et de chirurgie cervico-faciale, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - Yoann Pons
- Hôpital d'instruction des Armées-Percy, service d'ORL et de chirurgie cervico-faciale, 101, avenue Henri-Barbusse, 92140 Clamart, France
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El-Ayman YA, Naguib SM, Abdalla WM. Huge thyroglossal duct cyst in elderly patient: Case report. Int J Surg Case Rep 2018; 51:415-418. [PMID: 30360239 PMCID: PMC6168932 DOI: 10.1016/j.ijscr.2018.09.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 09/13/2018] [Indexed: 11/23/2022] Open
Abstract
85 years old male with huge long-standing (>60 years long) mid-line neck swelling. Clinical characters and radiology was consistent with Thyroglossal Duct Cyst. Sistrunk operation was successful, and pathology confirmed diagnosis. Healing was good, with no recurrence.
Introduction Thyroglossal duct cyst is the most common congenital neck mass. About 50% of cases present before the age of 10. A second group present in young adulthood. Case We present a case of an 85 years old male patient who presented to us with a huge swelling occupying the whole front of the neck, matching the characters of a thyroglossal cyst by history and clinical examination. The swelling first appeared in early adulthood. He received faulty advice that led him to believe that the operation was too risky. He lived without treatment or complications except for very slow progressive enlargement of the swelling over the years until it became cosmetically very bad and interfering with his daily activities. The swelling was cystic, non-tender with surrounding healthy skin except small area showing minimal signs of inflammation. Neck US and (CT) confirmed the diagnosis of thyroglossal cyst, 92*76 mm in size. Intervention We performed surgical excision of the cyst, tract and central part of hyoid bone (Sistrunk operation) and sent the specimen for histopathological evaluation, which confirmed pre-operative diagnosis. Conclusion Diagnosis of TGDC shouldn’t be excluded even in extremes of age, or extreme size, and can be managed according to standard lines of management.
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Garcia E, Osterbauer B, Parham D, Koempel J. The incidence of microscopic thyroglossal duct tissue superior to the hyoid bone. Laryngoscope 2018; 129:1215-1217. [PMID: 30194760 DOI: 10.1002/lary.27291] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Erick Garcia
- University of Southern California Keck School of MedicineLos Angeles California U.S.A
| | - Beth Osterbauer
- Division of Otolaryngology–Head and Neck SurgeryLos Angeles California U.S.A
| | - David Parham
- Department of Pathology and Laboratory MedicineChildren's Hospital Los AngelesLos Angeles California U.S.A
| | - Jeffrey Koempel
- Division of Otolaryngology–Head and Neck SurgeryLos Angeles California U.S.A
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27
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Wood CB, Bigcas JL, Alava I, Bischoff L, Langerman A, Kim Y. Papillary-Type Carcinoma of the Thyroglossal Duct Cyst: The Case for Conservative Management. Ann Otol Rhinol Laryngol 2018; 127:710-716. [DOI: 10.1177/0003489418791892] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objectives: Thyroglossal duct cyst (TGDC) is the most common congenital neck mass, presenting in up to 7% of the population. TGDC carcinoma is much less common, occurring in roughly 1% of patients diagnosed with TGDC. The vast majority of these tumors are papillary-type thyroid cancer. Given its rarity, there is wide variation in management recommendations for this disease. Extent of surgical management and need for adjuvant therapy including radioactive iodine ablation (RAI) are particularly debated, with some authors arguing aggressive therapy including RAI for any patients who undergo concurrent thyroidectomy with the Sistrunk procedure for TGDC carcinoma. We present a series of patients treated for TGDC carcinoma at our institutions and discuss our management algorithm. Methods: This is a retrospective chart review of patients with TGDC treated at 2 separate institutions. Factors reviewed included patient age, sex, preoperative diagnosis, preoperative work-up, extent of therapy, and use of adjuvant therapy. Results: Six patients who were treated for TGDC carcinoma at our institutions were identified. One patient was excluded because the patient had been treated at an outside facility prior to referral. All patients had papillary-type thyroid cancer. One patient underwent the Sistrunk procedure alone, and the remaining 4 underwent the Sistrunk procedure plus total thyroidectomy. Two of 4 patients were noted to have malignancy in the thyroid. Two of 4 patients who underwent thyroidectomy additionally received adjuvant RAI. Conclusion: Thyroglossal duct cyst carcinoma is uncommon and management is controversial. In low-risk patients (single tumor focus, negative margins, normal preoperative neck/thyroid imaging, no extension of TGDC carcinoma beyond the cyst wall), the Sistrunk procedure alone with observation of the thyroid may be sufficient. In this patient population, RAI is unlikely to be of any substantial benefit.
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Affiliation(s)
- C. Burton Wood
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jo-Lawrence Bigcas
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ibrahim Alava
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Lindsay Bischoff
- Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alexander Langerman
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Young Kim
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Alatsakis M, Drogouti M, Tsompanidou C, Katsourakis A, Chatzis I. Invasive Thyroglossal Duct Cyst Papillary Carcinoma: A Case Report and Review of the Literature. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:757-762. [PMID: 29950556 PMCID: PMC6053947 DOI: 10.12659/ajcr.907313] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Female, 27 Final Diagnosis: Invasive thyroglossal duct cyst papillary carcinoma Symptoms: Painless cervical enlargement Medication: — Clinical Procedure: Sistrunk’s procedure Specialty: Surgery
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Affiliation(s)
- Michael Alatsakis
- Department of Surgery, General Hospital of Thessaloniki, Agios Dimitrios, Thessaloniki, Greece
| | - Maria Drogouti
- Department of Surgery, General Hospital of Thessaloniki, Agios Dimitrios, Thessaloniki, Greece
| | - Chrysoula Tsompanidou
- Department of Pathology, General Hospital of Thessaloniki, Agios Dimitrios, Thessaloniki, Greece
| | - Anastasios Katsourakis
- Department of Surgery, General Hospital of Thessaloniki, Agios Dimitrios, Thessaloniki, Greece
| | - Iosif Chatzis
- Department of Surgery, General Hospital of Thessaloniki, Agios Dimitrios, Thessaloniki, Greece
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29
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Das DK, George SA, Mohammad T, John B, George SS, Behbehani AI. Papillary carcinoma in thyroglossal duct cyst: Diagnosis by fine-needle aspiration cytology and immunocytochemistry. Diagn Cytopathol 2018; 46:797-800. [DOI: 10.1002/dc.23968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 04/24/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Dilip K. Das
- Department of Pathology, Faculty of Medicine; Kuwait University; Safat Kuwait
- Cytology Unit; Mubarak Al-Kabeer Hospital; Jabriya Kuwait
| | | | - Tareq Mohammad
- Histopathology Unit; Mubarak Al-Kabeer Hospital; Jabriya Kuwait
| | - Bency John
- Department of Pathology, Faculty of Medicine; Kuwait University; Safat Kuwait
| | - Sara S. George
- Department of Pathology, Faculty of Medicine; Kuwait University; Safat Kuwait
| | - Abdulla I. Behbehani
- Department of Pathology, Faculty of Medicine; Kuwait University; Safat Kuwait
- Department of Surgery; Mubarak Al-Kabeer Hospital; Jabriya Kuwait
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30
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PALOMEQUE-VERA JM, FERNÁNDEZ-RUIZ E, LÓPEZ-HUELVA E, PLATERO-SÁNCHEZ-ESCRIBANO M, OLIVA-DOMÍNGUEZ M. Quiste tirogloso gigante. Descripción de un caso. REVISTA ORL 2018. [DOI: 10.14201/orl.18068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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31
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Povey HG, Selvachandran H, Peters RT, Jones MO. Management of suspected thyroglossal duct cysts. J Pediatr Surg 2018; 53:281-282. [PMID: 29305009 DOI: 10.1016/j.jpedsurg.2017.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022]
Abstract
AIM OF STUDY The aim of this study was to evaluate management of children with an anterior midline neck swelling by establishing 1) whether a preoperative ultrasound scan (USS) was appropriately requested, performed and reported; 2) whether there was preoperative infection; 3) whether a Sistrunk procedure was performed; 4) the rate of thyroglossal duct cyst (TGDC) recurrence following simple excision vs. Sistrunk procedure. METHODS A single centre retrospective study of children who underwent surgery for anterior midline neck swelling between April 2000 and May 2015 at our institution was performed. These were identified using a clinical coding system, and data were collected from electronic medical records, radiology, and histopathology reports. Recurrence rates between simple excision and Sistrunk groups were compared using Chi-square test. MAIN RESULTS 227 patients were identified (115 male, 112 female). 169 (74%) had a preoperative USS. The presence of a thyroid gland was stated in 79% of USS reports. This increased to 92% when the requesting surgeon had specifically asked about this. 48 (21%) patients underwent simple excision, while 175 (77%) had a Sistrunk procedure. Recurrence was significantly more likely following simple excision than a Sistrunk procedure (29% vs 6.9%; P<0.0001). Of 25 TGDC recurrences, 9 (36%) had an inconclusive or alternative histopathological diagnosis at first operation. CONCLUSION Preoperative USS should be performed in all patients with an anterior midline neck swelling. Appropriate requesting increases likelihood of a report confirming (or otherwise) the presence of a thyroid gland. A Sistrunk procedure is the operation of choice in all children presenting with an anterior midline neck swelling. The surgeon cannot reliably differentiate a TGDC from alternative pathology intraoperatively. LEVEL OF EVIDENCE Treatment study: level IV.
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Affiliation(s)
- Hannah G Povey
- Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool, UK
| | - Haran Selvachandran
- Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool, UK
| | - Robert T Peters
- Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool, UK
| | - Matthew O Jones
- Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool, UK.
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32
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Barber J, Martinez DS, Diaz FP, Stark AP, Livhits MJ. Intrathyroidal Thyroglossal Duct CYST: A Rare Cause of Thyroiditis in an Adult. AACE Clin Case Rep 2018. [DOI: 10.4158/ep171812.cr] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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33
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Abstract
Thyroglossal duct cyst (TDC) is the most common congenital anomaly of the thyroid gland and the most common congenital cervical abnormality in childhood. Carcinoma arising from a TDC is rare, which composes only 1% of TDC cases. Here, we are reporting a case of 50-year-old male with a swelling in the upper left neck region which was progressively increasing in size over 5 years. Ultrasonography report showed a large lobulated cystic mass. Internal echoes with calcification and there were no neck nodes. Thyroid gland was normal. In the present study, the Sistrunk procedure was used to excise a TDC. Papillary carcinoma was confirmed with the histopathological examination following the surgery. The patient was treated with radioactive iodide and thyroid suppression therapy was given as adjuvant treatment. The patient has been following for 2 years without any metastasis.
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Affiliation(s)
- Jitendra K Rathod
- Department of Otorhinolaryngology, M.G.M. Medical College, Aurangabad, Maharashtra, India
| | - Swati J Rathod
- Department of Oral Medicine and Radiology, C.S.M.S.S. Dental College and Hospital, Aurangabad, Maharashtra, India
| | - Vishwas Kadam
- Department of Oral Medicine and Radiology, C.S.M.S.S. Dental College and Hospital, Aurangabad, Maharashtra, India
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34
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Nightingale M. Midline cervical swellings: What a paediatrician needs to know. J Paediatr Child Health 2017; 53:1086-1090. [PMID: 29148189 DOI: 10.1111/jpc.13759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 08/25/2017] [Accepted: 08/29/2017] [Indexed: 11/30/2022]
Abstract
Midline cervical swellings are a heterogeneous group of conditions in children. Careful clinical examination will allow a diagnosis to be made in many instances and appropriate investigations to be performed before referral to surgical services. The approach to clinical examination, investigation and management of the most common conditions is described.
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Affiliation(s)
- Michael Nightingale
- Paediatric Surgery, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
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35
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Simultaneous Papillary Carcinoma in Thyroglossal Duct Cyst and Thyroid. Case Rep Endocrinol 2017; 2017:8541078. [PMID: 28270939 PMCID: PMC5320317 DOI: 10.1155/2017/8541078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 01/10/2017] [Indexed: 11/17/2022] Open
Abstract
Thyroglossal duct cyst (TDC) is a cystic expansion of a remnant of the thyroglossal duct tract. Carcinomas in the TDC are extremely rare and are usually an incidental finding after the Sistrunk procedure. In this report, an unusual case of a 36-year-old woman with concurrent papillary thyroid carcinoma arising in the TDC and on the thyroid gland is presented, followed by a discussion of the controversies surrounding the possible origins of a papillary carcinoma in the TDC, as well as the current management options.
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36
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Al-Hadidi A, Mohammed A, Morden R. Thyroglossal duct papillary carcinoma with squamous metaplasia in a 12-year old female and review of literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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37
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López-Gómez J, Salazar-Álvarez MA, Granados-Garcia M. Papillary carcinoma of hyoid. Int J Surg Case Rep 2016; 28:241-245. [PMID: 27750175 PMCID: PMC5070838 DOI: 10.1016/j.ijscr.2016.09.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/27/2016] [Accepted: 09/27/2016] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Thyroglosal duct cyst is a common anomaly with an incidence of 7% in adults, the rate of carcinoma in TGDC is 0.7-1.6%, and are extremely rare those originated in the hyoid bone. PRESENTATION OF CASE A 60 years old male patient, had a hard mass in the anterior neck. CT revealed a hyoid tumor. Hyoid bone resection was performed, the pathological report show a conventional papillary carcinoma in bone tissue. We rule out primary tumor in thyroid gland. Five years later, he developed a neck node recurrence. Total thyroidectomy and a selective left neck dissection (II-IV levels) was performed. He received radioiodine adjuvant treatment. DISCUSSION Hyoid cancer originates of a persistent thyroglosal duct remnants inside hyoid bone. CONCLUSION We propose to add a new subdivision to pathology derived from thyroglosal duct remnants). The diagnostic approach with ultrasound and CT are necessary. A primary in te hyoid gland mustang be discorded, and then the entire hyoid bone must be removed. Treatment of the thyroid gland and neck should be considered when there are significant risk factors of recurrence, similarly to thyroid cancer based on the risk assessment.
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Affiliation(s)
- Javier López-Gómez
- Department of Oncologic Surgery, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico.
| | - Ma Alejandra Salazar-Álvarez
- Department of Oncologic Surgery, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico.
| | - Martin Granados-Garcia
- Department of Head and Neck, National Cancer Institute, Mexico City, Av. San Fernando No. 22, Col. Sección XVI, C.P. 14080, Mexico.
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38
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Carroll DJ, Byrd JK, Harris GF. The feasibility of pediatric TORS for lingual thyroglossal duct cyst. Int J Pediatr Otorhinolaryngol 2016; 88:109-12. [PMID: 27497396 DOI: 10.1016/j.ijporl.2016.06.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/13/2016] [Accepted: 06/16/2016] [Indexed: 10/21/2022]
Abstract
A six-year-old boy who presented with symptoms of obstructive sleep apnea was found to have a midline tongue mass suspicious for lingual thyroglossal duct cyst (TGDC). Surgery was scheduled after workup confirmed the presence of functional, orthotopic thyroid tissue. The surgical robot was used to excise the mass endoscopically without removing any hyoid. He was extubated at the conclusion of the case. The child tolerated a soft diet and was discharged after an uneventful overnight stay in the ICU. Pathology confirmed TGDC. There have been no reported issues in eleven months of follow-up. Our report adds to the scarce literature on performing such a surgery in a child and demonstrates that with the correct circumstances, prompt extubation, discharge, and prolonged remission are possible.
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Affiliation(s)
- Daniel J Carroll
- Department of Otolaryngology, Augusta University, Augusta, GA, USA.
| | - James K Byrd
- Department of Otolaryngology, Augusta University, Augusta, GA, USA.
| | - George F Harris
- Department of Otolaryngology, Augusta University, Augusta, GA, USA.
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39
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Atmaca S, Çeçen A, Kavaz E. Thyroglossal Duct Cyst in a 3-Month-Old Infant: A Rare Case. Turk Arch Otorhinolaryngol 2016; 54:138-140. [PMID: 29392034 DOI: 10.5152/tao.2016.1636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/14/2016] [Indexed: 11/22/2022] Open
Abstract
Thyroglossal duct cyst (TGDC) is the most common congenital midline neck mass in children. It usually becomes symptomatic following a respiratory tract infection and is usually diagnosed at 5 years of age. Thyroglossal duct cyst is rarely observed in less than 1-year-old infants. In this study, we present a 3-month-old infant with TGDC, who was administered multiple courses of antibiotic therapy for the hyperemic, draining, midline neck mass that had existed since he was 15 days old. Physical examination revealed an infrahyoid midline neck mass measuring 3×3 cm, which moved while swallowing and had a sinus opening in the overlying skin. The patient underwent Sistrunk operation under general anesthesia. Histopathologic examination revealed TGDC. One-year follow-up revealed no recurrence.
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Affiliation(s)
- Sinan Atmaca
- Department of Otorhinolaryngology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ayşe Çeçen
- Department of Otorhinolaryngology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Esra Kavaz
- Department of Otorhinolaryngology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
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40
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Dremmen MH, Tekes A, Mueller S, Seyfert D, Tunkel DE, Huisman TA. Lumps and Bumps of the Neck in Children-Neuroimaging of Congenital and Acquired Lesions. J Neuroimaging 2016; 26:562-580. [DOI: 10.1111/jon.12376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/18/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
- Marjolein H.G. Dremmen
- Division of Pediatric Radiology and Pediatric Neuroradiology, Department of Radiology and Radiological Science; Johns Hopkins Hospital; Baltimore MD
- Division of Pediatric Radiology, Department of Radiology; Erasmus MC - University Medical Center Rotterdam; Rotterdam The Netherlands
| | - Aylin Tekes
- Division of Pediatric Radiology and Pediatric Neuroradiology, Department of Radiology and Radiological Science; Johns Hopkins Hospital; Baltimore MD
| | - Samantha Mueller
- Division of Pediatric Radiology and Pediatric Neuroradiology, Department of Radiology and Radiological Science; Johns Hopkins Hospital; Baltimore MD
| | - Donna Seyfert
- Division of Pediatric Radiology and Pediatric Neuroradiology, Department of Radiology and Radiological Science; Johns Hopkins Hospital; Baltimore MD
| | - David E. Tunkel
- Division of Pediatric Otolaryngology; Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins Hospital; Baltimore MD
| | - Thierry A.G.M. Huisman
- Division of Pediatric Radiology and Pediatric Neuroradiology, Department of Radiology and Radiological Science; Johns Hopkins Hospital; Baltimore MD
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Wide anterior neck dissection for management of recurrent thyroglossal duct cysts in adults. The Journal of Laryngology & Otology 2016; 130 Suppl 4:S41-4. [PMID: 27488336 DOI: 10.1017/s0022215116008239] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE 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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42
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Loh WS, Chong SM, Loh KS. Intralaryngeal Thyroglossal Duct Cyst: Implications for the Migratory Pathway of the Thyroglossal Duct. Ann Otol Rhinol Laryngol 2016; 115:114-6. [PMID: 16514793 DOI: 10.1177/000348940611500206] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An atypically located thyroglossal duct cyst in a 42-year-old man is described. A purely intralaryngeal thyroglossal duct cyst is extremely rare and can mimic other laryngeal lesions. This case demonstrates that thyroglossal duct cyst is a possible cause of intralaryngeal swellings and would have significant implications for the manner in which they are managed.
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Affiliation(s)
- Woei Shyang Loh
- Dept of Otolaryngology, National University of Singapore, 5 Lower Kent Ridge Road, Singapore, Republic of Singapore 119074
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43
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The extent of surgery in thyroglossal cyst carcinoma. Langenbecks Arch Surg 2016; 402:799-804. [PMID: 27339199 DOI: 10.1007/s00423-016-1460-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/06/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The optimal management of thyroglossal cyst carcinoma, particularly the extent of surgery required is controversial. The aim of this study was to evaluate the need for routinely adding total thyroidectomy to Sistrunk's operation in the management of this condition. METHODS The clinical records of 19 patients with a diagnosis of thyroglossal cyst carcinoma encountered in an 11-year period (2004-2015) were reviewed. All patients underwent total thyroidectomy in addition to Sistrunk's procedure. The rate of concomitant thyroglossal cyst and thyroid carcinomas was calculated and cancers were staged according to the AJCC-TNM staging system. Patients were divided into two groups: those with thyroglossal cyst carcinoma only (group A) and those with a synchronous or metachronous thyroid carcinoma as well (group B). The need for radioactive iodine ablation in group A was assessed. The ability to omit total thyroidectomy based on thyroglossal cancer size and a negative thyroid ultrasound was also evaluated. RESULTS The rate of concomitant thyroid cancer was 63.2 % (12/19). Based on stage, three out of the seven patients in group A required radioactive iodine ablation. Total thyroidectomy was ultimately justifiable in 78.9 % (15/19) of cases. Omitting total thyroidectomy in T1 thyroglossal cyst cancers or based on a sonographically normal thyroid was associated with a 43 % risk of missing thyroid malignancy. CONCLUSION The routine addition of total thyroidectomy to Sistrunk's procedure seems to be appropriate for comprehensive loco-regional control especially that selecting a subset of patients in which it could be omitted is a difficult task.
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A Clinicopathologic Series of 685 Thyroglossal Duct Remnant Cysts. Head Neck Pathol 2016; 10:465-474. [PMID: 27161104 PMCID: PMC5082048 DOI: 10.1007/s12105-016-0724-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
The clinical features of thyroglossal duct remnant cysts (TGDC) have been well described, however the histopathologic aspects of these lesions have not been addressed in a detailed manner. In particular, there has been no large community practice based series evaluating TGDC histologically compared with management outcomes. A retrospective review of all TGDC diagnosed between 2005 and 2015 was performed. Six hundred eighty-five patients were identified (344 males; 341 females). Age at presentation was bimodal (first and fifth decades) and ranged from 0.8 to 87 years (mean 31.3 years). Males predominate in children (150:111); females in adults (230:194). Patients presented most frequently with a mobile midline neck mass in an infrahyoid location. An associated skin fistula (n = 67) was twice as common in pediatric as adult patients. The average cyst size was 2.4 cm (range 0.4-9.9 cm) by imaging studies and 2.6 cm (range 0.2-8.5 cm) by pathologic examination; pediatric patients had smaller cysts (mean 2.1 cm) than adults (mean 2.8 cm). Histologically, 257 (38 %) TGDC were lined by respiratory epithelium alone, 68 (10 %) squamous epithelium alone, 347 (51 %) exhibited both respiratory and squamous epithelium, and 13 (1 %) had no identifiable epithelial lining. Four hundred eighty-four (71 %) TGDC had associated thyroid gland tissue present within the cyst wall (n = 282), skeletal muscle (n = 71), adipose tissue (n = 34), or a combination of these sites (n = 97). The hyoid bone was identified in 647 (grossly and/or histologically), and absent in 38. Surgical management consisted of Sistrunk procedure (n = 647), cystectomy (n = 31), or thyroidectomy/thyroid lobectomy (n = 7). Treatment related complications were observed in 6 patients, which included vocal cord damage, seroma, and hematoma. Recurrences developed in 20 (3 %) patients, 14 of whom were managed initially by cystectomy. Papillary thyroid carcinoma was identified in 22 (3.2 %) TGDC. In summary, TGDC show a bimodal peak in the 1st and 5th decades, commonly presenting as a midline cervical lesion below the hyoid bone, associated with a skin fistula in 10 %. Histologically TGDC are most commonly lined by a combination of respiratory and squamous epithelium. Thyroid gland tissue is identified in 71 % of cases (0.45 cm mean size), although not limited to the cyst wall, but present in the surrounding soft tissues. Rare TGDC may harbor malignancy (3.2 %). TGDC are most effectively managed by Sistrunk procedure rather than excision, which carries low rates of complications (1 %) and recurrence (3 %).
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45
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Abstract
Thyroglossal duct cyst is a frequent event; however, papillary carcinoma within a thyroglossal duct cyst is rare, particularly in children. A 17-year-old girl presented with an asymptomatic mid-submental mass for the last 2 months. The diagnosis of thyroglossal duct cyst was made based on physical examination and computed tomography finding. After performance of Sistrunk procedure, an incidental papillary carcinoma within the thyroglossal duct cyst was observed on pathology. We reviewed the pediatric cases of thyroglossal duct carcinoma, and then decided not to perform a concurrent thyroidectomy. We will continue close follow-up for future thyroid involvement.
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Chang YS, Su HH, Ho SP. Adenosquamous carcinoma arising from a thyroglossal duct cyst: A case report. Oncol Lett 2016; 11:2668-2672. [PMID: 27073536 DOI: 10.3892/ol.2016.4262] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 01/26/2016] [Indexed: 11/05/2022] Open
Abstract
The current study describes a case of adenosquamous carcinoma originating from a thyroglossal duct cyst (TGDC). A 77-year-old man presented with an asymptomatic mass in the left mid-neck, which was soft and mobile on palpation. Fine-needle aspiration was performed, but cytology did not detect any malignant cells. Computed tomography demonstrated a single cystic lesion in the left lobe of the thyroid gland; therefore, surgery was performed on the suspected thyroid cyst. However, it was identified intraoperatively that the lesion was separated from the thyroid gland and instead adhered to an additional hyoid bone; therefore, the Sistrunk procedure was performed. Histopathological examination of the resected tumor confirmed the diagnosis of adenosquamous carcinoma originating from a TGDC. Carcinoma arising from a TGDC is rare, and accounts for 1% of all TGDC cases. The most common subtype of carcinoma associated with TGDC is papillary carcinoma, whilst adenosquamous carcinoma developing from a TGDC is extremely rare, with only one case currently reported in the literature. Although a consensus for the management of this disease has not yet been established, adequate surgical excision with long-term follow-up is currently the preferred treatment.
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Affiliation(s)
- Yu-Sung Chang
- Department of Otolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
| | - Hsin-Hao Su
- Department of Otolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
| | - Szu-Pei Ho
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
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Inoue K, Bando Y, Sakiyama K, Takizawa S, Sakashita H, Kondo H, Amano O. Development and regression of the thyroglossal duct in mice. Ann Anat 2015; 200:54-65. [DOI: 10.1016/j.aanat.2015.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 12/25/2014] [Accepted: 01/29/2015] [Indexed: 11/30/2022]
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49
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Pyramidal lobe of the thyroid gland and the thyroglossal duct remnant: A study using human fetal sections. Ann Anat 2015; 197:29-37. [DOI: 10.1016/j.aanat.2014.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 09/12/2014] [Accepted: 09/25/2014] [Indexed: 12/20/2022]
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50
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Abstract
Dermoid cysts are malformations that are rarely seen in the oral cavity. An intraoral dermoid cyst grows slowly, but may enlarge and interfere with deglutition and speech, or can pose a critical risk to the airway and therefore require immediate surgical intervention. Dermoid cysts may develop above or below the mylohyoid muscle, causing a submental or submandibular swelling. Surgical excision is the treatment of choice and recurrence is rare. An intraoral approach for the treatment of large lesions presenting above the mylohyoid muscle provides good cosmetic and functional results. We report a case of a 26-year-old female who developed an epidermoid cyst presenting as a large sublingual swelling causing speech and swallowing difficulties. The lesion was surgically excised using an intraoral approach. Microscopic examination revealed a dermoid cyst of the epidermoid type. This case shows that dermoid cysts may be successfully diagnosed and managed using a series of simple yet effective clinical procedure.
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Affiliation(s)
- Mohan Baliga
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - Nandita Shenoy
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - Dharnappa Poojary
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - Ram Mohan
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - Ramdas Naik
- Department of Oral Medicine and Radiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
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