Thyroglossal Duct Cysts – A ten years retrospective review

Year 2014, Volume: 19 Issue: 2, 112 - 118, 05.12.2014

Eyzawiah Hassan , Goh Bee See , Dayang Anita Aziz

Abstract

Background: Thyroglossal duct cyst (TDC) is the most common congenital midline anterior neck mass which may present at any age particularly in the pediatric age group.
Objective: To review the pre-operative evaluation and the subsequent management in patients diagnosed with TDC.

Methods: Medical records of all the patients diagnosed with TDCs from January 2001 till December 2010 were retrospectively reviewed. The patients’ clinical presentations, types of radiological investigation performed, the surgery and the outcome were documented.

Results: There were 23 records of patients identified, but only 12 records were included due to incomplete data. They were 7 female and 5 male. The age ranged from 2 to 58 years. Mean age of presentation was 11.8 years. Eighty three percent of patients were in the pediatric age group. Ten cases (83%) presented as a painless neck swelling and a case with discharging cyst (8.3%) and infected cyst (8.3%). Ultrasound of the neck was the most common radiological investigation performed prior to surgery. All patients underwent Sistrunk operation. The histopathological examination of the excised specimens was confirmed as thyroglossal duct cyst; in one patient papillary carcinoma was identified. There were no post-operative complications or recurrence.

Conclusions: TDCs may manifest at any age but most commonly in pediatric age group. Diagnosis is usually be made clinically. Ultrasound of the thyroid gland and the neck structures is an adequate tool of investigation; however other adjunct investigations may be required. Sistrunk operation is the surgery of choice at our centre with no recurrence documented.

Keywords

Thyroglossal duct cysts, ultrasound, Sistrunk, neck

References

• Allard R.H.B.The thyroglossal cyst. Head Neck Surg. 1982; 5: 143—146.
• Ellis PD, van Nostrand AW. The applied anatomy of thyroglossal tract remnants. Laryngoscope 1977; 87: 765-7
• Mondin V, Ferlito A, Muzzi E, et al. Thyroglossal duct cyst: personal experience and literature review. Auris Nasus Larynx 2008; 35: 11-25.
• Pollock WF, Stevenson EO. Cysts and sinuses of the thyroglossal duct. Am J Surg 1966; 112: 225-232. Ducic Y, Chou S, Drkulec J, Ouellette H, Lamothe A. Recurrent thyroglossal duct cysts: a clinical and pathologic analysis. Int J Pediatr Otorhinolaryngol 1998; 44: 47-50.
• Ghaneim A, Atkins P. The management of thyroglossal duct cysts. Int J Clin Pract 1997; 51: 512–513.
• Kennedy TL, Whitaker M, Wadih G. Thyroglossal duct carcinoma: a rational approach to management. Laryngoscope 1998; 108: 1154-1158.
• Waddell A, Saleh H, Robertson N, Khalil HS, Bridger MW. Thyroglossal duct remnants. J Laryngol Otol 2000; 114: 128-129.
• Dedivitis RA, Camargo DL, Peixoto GL, Weissman L, Guimarães AV. Thyroglossal duct: a review of 55 cases. J Am Coll Surg 2002; 194: 274-277.
• Hsieh YY, Hsueh S, Hsueh C, et al. Pathological analysis of congenital cervical cysts in children: 20 years of experience at Chang Gung Memorial Hospital. Chang Gung Med J 2003; 26: 107-113. Sprinzl GM, Koebke J, Wimmers-Klick J, Eckel HE, Thumfart WF. Morphology of the human thyroglossal tract: a histologic and macroscopic study in infants and children. Ann Otol Rhinol Laryngol 2000; 109: 1135-1139.
• Brousseau VJ, Solares CA, Xu M, Krakovitz P, Koltai PJ. Thyroglossal duct cysts: presentation and management in children versus adults. Int J Pediatr Otorhinolaryngol 2003; 67: 1285-1290.
• Clute HM, Cattell RB. THYROGLOSSAL CYSTS AND SINUSES. Ann Surg 1930; 92: 57-66.
• McCLINTOCK JC, MAHAFFEY DE. Thyroglossal tract lesions. J Clin Endocrinol Metab 1950; 10: 11081
• DALGAARD JB, WETTELAND P. Aberrant thyroid tissue. II. Thyroglossal anomalies; a follow-up study of 58 cases. Acta Chir Scand 1956; 111: 444-455. BROWN PM, JUDD ES. Thyroglossal duct cysts and sinuses: results of radical (Sistrunk) operation. Am J Surg 1961; 102: 494-501.
• Josephson GD, Spencer WR, Josephson JS. Thyroglossal duct cyst: the New York Eye and Ear Infirmary experience and a literature review. Ear Nose Throat J 1998; 77: 642-651.
• Ostlie DJ, Burjonrappa SC, Snyder CL, et al. Thyroglossal duct infections and surgical outcomes. J Pediatr Surg 2004; 39: 396-399.
• Mondin V, Ferlito A, Muzzi E, et al. Thyroglossal duct cyst: personal experience and literature review. Auris Nasus Larynx 2008; 35: 11-25.
• Kanawaku Y, Funayama M, Sakai J, Nata M, Kanetake J. Sudden infant death: lingual thyroglossal duct cyst versus environmental factors. Forensic Sci Int 2006; 156: 158-160.
• Hossam Thabet, Alaa Gaafar, Yasser Nour. Thyroglossal duct cyst Variable presentations.Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 2011; 12: 13–20.
• Davenport M. ABC of general surgery in children. Lumps and swellings of the head and neck. BMJ 1996; 312: 368-371.
• Ahuja AT, King AD, Metreweli C. Sonographic evaluation of thyroglossal duct cysts in children. Clin Radiol 2000; 55: 770-774.
• Sherman NH, Rosenberg HK, Heyman S, Templeton J. Ultrasound evaluation of neck masses in children. J Ultrasound Med 1985; 4: 127-134.
• Ahuja AT, Wong KT, King AD, Yuen EH. Imaging for thyroglossal duct cyst: the bare essentials. Clin Radiol 2005; 60: 141-148.
• Radkowski D, Arnold J, Healy GB, et al. Thyroglossal duct remnants. Preoperative evaluation and management. Arch Otolaryngol Head Neck Surg 1991; 117: 1378-1381.
• Noyek AM, Friedberg J. Thyroglossal duct and ectopic thyroid disorders. Otolaryngol Clin North Am 1981; 14: 187-201.
• Lim-Dunham JE, Feinstein KA, Yousefzadeh DK, Ben-Ami T. Sonographic demonstration of a normal thyroid gland excludes ectopic thyroid in patients with thyroglossal duct cyst. AJR Am J Roentgenol 1995; 164: 1489-1491.
• Shahin A, Burroughs FH, Kirby JP, Ali SZ. Thyroglossal duct cyst: a cytopathologic study of 26 cases. Diagn Cytopathol 2005; 33: 365-369.