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A thyroglossal duct cyst (TGDC) is the most common congenital anterior neck mass. It can develop from residual tissue not degenerated during development and is mainly diagnosed in pediatric patients. However, a TGDC is sometimes diagnosed for the first time in adult patients. A TGDC is mainly caused by repeated infections of the duct and there might be no specific symptoms. A TGDC can occur anywhere from the floor of the mouth to the thyroid but is most often found at the infrahyoid level. Over the past 10 years, there has been no report of a TGDC in the suprasternal region among TGDCs in unusual locations. This paper describes one case of a suprasternal TGDC with a review of the literature on this topic. [ABSTRACT FROM AUTHOR]

BACKGROUND: Thyroid cancer is the most common cervical neoplasm, these tend to have a nodular and solid appearance on imaging; however, cystic components may occur in 2.5%-6%. Among the most frequent causes of cystic lesions are the anomalies of the branchial arches and thyroglossal cyst; however, these lesions can occur in the context of well-differentiated thyroid cancer. It is important to know the differential diagnoses in these atypical presentations for a correct approach and treatment. CLINICAL CASE: A 40-year-old male patient with a growing mass in the right neck for 6 months. On physical exam a 7 x 7 cm tumor was palpated with regular and smooth edges, mobile. Imaging studies revealed a right thyroid nodule and a hypodense mass with well-defined and regular borders, antero-medial to the sternocleidomastoid muscle. A total thyroidectomy with central lymph node dissection and resection of the right cervical cyst was performed. The histopathological results showed a papillary thyroid carcinoma and a thyroglossal cyst. CONCLUSIONS: The correct diagnosis of cystic masses of the neck is important due to its different implications in the therapeutic approach. Although these usually have a benign behavior, we always have to take into account the possibility of a metastasis or a relationship with some malignant component. [ABSTRACT FROM AUTHOR]

Thyroglossal duct cysts (TGDCs) are congenital and developmental abnormalities in infants and young children. This retrospective case series study examined the characteristics of 7 patients <3 years (mean age, 1.9 years) with TGDC complicated with a parapharyngeal mass treated at one hospital between January 2019 and 2022. Four patients had a painless mass around the neck, 2 had a painless mass associated with snoring, and 1 presented repeated swelling and pain. B-ultrasound suggested 6 cases of TGDC and 1 possible lymphangioma. All patients were treated with Sistrunk surgery to remove the TGDC. Six patients had no cyst recurrence during follow-up (6 months to 2 years). In conclusion, TGDC complicated with a parapharyngeal mass has complex and variable clinical manifestations. Completely removing the cyst while sparing thyroid cartilage and surrounding vascular and neuroanatomical structures is important to avoid complications. The patients are likely to be free from recurrence after surgery. [ABSTRACT FROM AUTHOR]

Introduction. Congenital tongue base cysts are uncommon in everyday clinical practice and they could be asymptomatic or cause stridor, respiratory distress and asphyxia. We are presenting a case of two-month-old infant with the symptoms of stridor and the acute respiratory insufficiency caused by congenital tongue base cyst. Case outline. A two-month-old apyretic male infant was admitted to hospital with the symptoms of severe dyspnea, nonproductive cough and stridor. Due to severe respiratory insufficiency the infant was on mechanical ventilation. Computed tomography scans of thorax and neck was performed along with the application of the intravenous contrast where a cystic formation was shown. The depicted formation narrowed the lumen of oropharynx which is the same as the size of valleculas (3 mm). The formations pressed both valleculas, more significantly the left one. The same day the marsupialization of the cyst was done and the material was sent to the pathohistological analysis (the report of the pathologist indicates the cyst of the thyroid channel). Conclusion. Clinical manifestations of cyst depend on the level of obstruction and can be presented as inspiratory stridor, apnea, cyanosis, chronic coughing and feeding difficulty. The flexible nasopharyngeal laryngoscopy or bronchoscopy, CT and MR imaging help consider the differential diagnosis. The symptoms of stridor were removed completely after applied marsupialization of the cyst.

Dear Editor, A 62-year-old woman, with no medical co-morbidities, presented with a midline neck swelling that had evolved over eight years. She denied neck irradiation in childhood and had neither associated hypo- nor hyperthyroidism nor any pressure symptoms. Examination revealed a 4×3×2 cm non tender, firm, globular mass with a smooth surface and regular margins. It moved up on deglutition and tongue protrusion. There was no cervical lymphadenopathy or thyroid nodules [Table/Fig-1].

Thyroglossal cyst (TGC) is the most common congenital anomaly of the thyroid gland and is found in approximately 7% of general population. It represents cystic degeneration of a remnant of the thyroglossal duct that failed to involute during gestation. Malignancy occurring in TGC is rare entity, accounting only for 1% of all thyroglossal cysts. We are presenting such a rare case of papillary thyroid carcinoma arising in a thyroglossal cyst. 30-year-old female presented with a painless, gradually progressive swelling below the chin extending to left side. On examination, swelling was noted in submental region and measuring 4 × 3 × 1 cm, firm in consistency and moves with deglutition and movement of tongue. On radiological investigations, lobulated cystic lesion in midline with thin septations was seen, suggestive of thyroglossal cyst. The thyroid of the patient was normal. Patient underwent Sistrunk procedure. On histopathology, papillary thyroid carcinoma in thyroglossal cyst was seen and it was invading cyst wall and superficial skeletal muscle. The 1st case of thyroglossal duct carcinoma was reported by Brentano in 1911. Till now 300 cases have been reported in literature. Carcinomas occurring in thyroglossal cyst are extremely rare, (< 1% cases). The most frequent histological type is papillary pattern followed by mixed(papillary and follicular), squamous cell, Hürthle cell, follicular and anaplastic variety. The etiology of thyroglossal duct carcinoma is unknown and neither good clinical history nor examination can lead to a preoperative diagnosis. Diagnosis is often incidental on histopathology as in present case. Thyroglossal duct carcinoma is a rare condition that comes as a surprise to both the patient and surgeon and should be considered in patients presenting with cystic midline neck masses. [ABSTRACT FROM AUTHOR]

Introduction. In spite of being inaccurate in terms of suprahyoid dissection, Sistrunk's procedure is the gold-standard technique in the treatment of thyroglossal cyst. Since it was first described in 2014, the modifications introduced by Koempel have allowed for a more reproducible suprahyoid approach. We present our initial experience with this technique. Methods. A retrospective study of patients with thyroglossal cyst undergoing Koempel's technique in our institution from 2021 to 2022 was carried out. Demographic, clinical, and histological data was collected. Results. In the study period, 5 patients --3 girls and 2 boys-- underwent surgery. Median age and weight were 5 years (2-6) and 16 kg (14-25), respectively. All patients had suffered from previous infections, with 60% having cutaneous fistulization. In 2 patients, surgery was indicated following Sistrunk's procedure as a result of recurrence. Median operating time was 77 minutes (57-110), with the genioglossal muscle plane being identified in the 5 patients. No immediate complications were recorded, and diagnosis of thyroglossal cyst was histologically confirmed in all cases. One of the formerly recurrent patients had recurrence following surgery, but it was subclinical and incidentally diagnosed at control ultrasonography. The remaining patients had no recurrences after a median 8-month (1-12) follow-up period. Conclusions. Koempel's technique allows for a safe and reproducible approach of the suprahyoid segment. It is an attractive option in complicated cases as a result of previous infection or recurrence. [ABSTRACT FROM AUTHOR]

Background: Midline developmental neck lesions primarily consist of thyroglossal duct remnants. Their recurrence is uncommon following thorough resection, which includes hyoid removal (the Sistrunk procedure). Case report: A 3-year-old girl presented with mucoid secretion drainage and swelling in the anterior mid-neck region, clinically resembling a thyroglossal duct remnant. Following an initial Sistrunk procedure, the lesion recurred, prompting a subsequent resection. Histological analysis revealed a mucocele alongside acinar and mucous ectopic salivary glands. Conclusions: The ectopic salivary gland can manifest along the midline of the neck and may clinically resemble the signs and symptoms of a thyroglossal duct cyst. Importantly, it can exhibit recurrence post-surgery, even following hyoid resection [ABSTRACT FROM AUTHOR]

As one of the most common congenital neck lesions, thyroglossal duct cyst (TDC) accounts for approximately 70% of midline cervical masses in children. Early surgery is recommended. With continuous technical refinements and the deepening of understanding, surgical approaches of the disease have become more mature and diverse. This review summarized the surgical modalities of pediatric TDC to guide a proper selection of treatments. [ABSTRACT FROM AUTHOR]

Thyroglossal cyst is seen in approximately 7 % of the population. It is the most common congenital anomaly of neck and it is found anywhere between base of the tongue and the level of 1st tracheal ring. Most cases are diagnosed before 10 years of age. Classically, the swelling moves with protrusion of the tongue and deglutition. Radiologically, most of the cysts demonstrate a tract with communication to hyoid bone or thyroid gland. Our case report is that of a 45 year old lady who had a thyroglossal cyst in the suprasternal notch, which is an unusual presentation. However, it had no thyroglossal tract identified radiologically, intra operatively or by histopathology. [ABSTRACT FROM AUTHOR]

Thyroglossal duct cyst (TGDC) rarely becomes symptomatic in the neonatal period unlike other congenital neck swellings which present with high airway obstruction. An infrahyoid TGDC presenting with airway compromise in a neonate is even rarer. We hereby report a newborn with significant respiratory distress necessitating intubation and ventilation since birth. He had multiple extubation failures and signs of upper airway obstruction post-extubation. Computed tomography demonstrated a cystic lesion, probably an infrahyoid TGDC compressing the laryngeal lumen. The cyst was removed by Sistrunk procedure and histopathology confirmed the diagnosis. The child was discharged 5 days after surgery and was asymptomatic on follow-ups. [ABSTRACT FROM AUTHOR]

Sistrunk procedure for thyroglossal duct cyst (TGDC) includes removal of the thyroglossal cyst, middle portion of the hyoid bone and the tract towards the foramen caecum. Endoscopic approaches have surpassed the traditional open approaches for the treatment of benign thyroid swellings and TGDCs. Endoscopic Sistrunk procedure using bilateral axillo-breast approach is a safe and better alternative for the successful treatment of TGDC and provides excellent cosmetic results.

The article describes the case of a 62-year-old woman with a midline neck swelling that had evolved over eight years and was diagnosed with thyroglossal duct cyst carcinoma.

Background Thyroid disease poses a major clinical problem. Knowledge of the pattern and distribution of thyroid disease is important to establish prevention and treatment protocols. This is hampered by lack of data. Methods This is a retrospective descriptive study of histopathology reports on thyroid tissue surgically excised from patients over a 10-year-period (from 2009-2020) at a major teaching hospital. Demographic data on patients included the age, gender, geographical location and ethnic origin. Results A total of 1351 histopathological reports on thyroid patients were studied. Twenty one patients (1.6%) had thyroglossal cysts and 1330 patients (98.4%) had goiters. The mean age was 40.6 years (SD±13.25), (range 11-85years). The majority (88%) were females Most of our patients come from Khartoum (76.3%), followed by White Nile (6.4%), and El Gazira states (4.5%). The commonest ethnic groups affected were the Nuba (11.6%) and Jaalin (8%). The majority of patients (85%) had benign thyroid diseases, and only (15%) had neoplastic disease. Simple multinodular goiter (SMNG) accounted for (78.6%) of benign thyroid disease. Follicular adenoma was the commonest benign neoplasm (98%), whereas papillary carcinoma was the commonest malignant tumour (44.9%), followed by follicular carcinoma and Hurthle cell tumours (43.9%). Medullary and anaplastic carcinomas each accounted for (4.1%) of patients. Conclusions The study identified the histopathological pattern of thyroid disease. SMNG was the commonest benign disease. Follicular and Hurtle cell carcinoma combined were almost as frequent as papillary carcinoma. Prevention of SMNG by iodinization, early detection of thyroid neoplasms, and studies on goitrogens should be activated. [ABSTRACT FROM AUTHOR]

Lingual thyroid is a very rare anomaly and is usually incidentally found in patients that have hypothyroidism or mass in throat. This case however had another mass in the submandible with diagnosis of thyroglossal cyst. Thyroglossal duct cyst is the most common congenital neck mass. About 50% of cases present before the age of 10 and second group age present in young adulthood. We present a 27-year-old man who presented with sub-mental mass. The patient had also hypothyroidism. A CT scan was performed to confirm the diagnosis. The CT scan confirmed submental cyst and incidentally discovered lingual thyroid along with absence of thyroid tissue in its normal pretracheal position. The patient had symptoms of hypothyroidism and he was treated with levothyroxin. Our case report highlights a rare and unusual situation because of the coexistence of a thyroglossal cyst and a partially functional lingual thyroid. [ABSTRACT FROM AUTHOR]

We describe a case of papillary carcinoma in a thyroglossal cyst with left hemiagenesis of the thyroid gland in a 24-year-old female patient. We opted not to perform a total thyroidectomy as the patient was at low risk for aggressive disease. In this article we review the criteria for selection of thyroidectomy in incidentally discovered papillary carcinomas after thyroglossal cyst excision and management protocol in case of coexisting thyroid hemi-agenesis. To our knowledge, this case represents the second case report of an association between left thyroid hemiagenesis and thyroglossal duct cyst papillary carcinoma. [ABSTRACT FROM AUTHOR]

A thyroglossal duct cyst is the most common congenital cyst in the cervical region. Thyroid papillary carcinoma incidence in thyroglossal duct cysts is considered to be low. In most cases, the diagnosis of thyroglossal duct cyst papillary carcinoma is made postoperatively. We present a 62-year-old male with thyroid papillary carcinoma which developed from a thyroglossal duct cyst. This was confirmed in a pathologic study after operation. In our case, there was neither lymph node involvement nor invasion of adjacent tissue. The patient then underwent total thyroidectomy along with the Sistrunk operation. Later on, the patient was given adjuvant treatment with radioactive iodide and thyroid suppression therapy. The patient was followed up for one year without any metastasis or recurrence., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alrohaimi et al.)

Objectives: Thyroglossal cysts (TGCs) usually present during childhood and before the age of 30, however, they can also be seen in adults, even in advanced age. Nodular thyroid disease is also common in adults. In the literature, there is an ongoing debate regarding the differences in clinical presentation, gender, and postoperative recurrence of TGC between children and adults. In this study, we aimed to process the data of adult patients who underwent surgery for TGC in our clinic, along with the data on concurrent thyroid disease and thyroid surgery., Methods: The data of patients over 18 years old who were operated on for TGC at the General Surgery Clinic of Sisli Hamidiye Etfal Training and Research Hospital between 2018 and 2024 were retrospectively evaluated., Results: A total of 16 patients with a mean age of 43.94±12.98 (21-67) years, were included in the study (11 F/5 M). The diagnosis of TGC was made in 12 patients (75%) by ultrasonography (USG), in 1 patient (6.25%) by computed tomography, in 1 patient (6.25%) by magnetic resonance imaging (MRI), and in 2 patients (12.5%) incidentally intraoperatively. 13 patients (81.25%) underwent the Sistrunk procedure, and 3 patients (18.75%) underwent cyst excision. Among the 16 TGC patients, papillary thyroid cancer in the cyst was detected in one patient (6.25%) preoperatively. During preoperative evaluation, nodular thyroid disease was found in 12 patients (75%). Of these, papillary thyroid cancer was detected in 3 patients (18.75%) preoperatively. Of the TGC group, 3 (18.75%) underwent thyroidectomy for thyroid malignancy, and five (31.25%) underwent additional thyroid surgery for nodular thyroid disease. The patients were followed for a mean of 22.63±18.32 months (3-67 months), and no recurrence of TGC was observed during the follow-up period., Conclusion: In patients with TGC, thyroid diseases and the requirement for thyroidectomy due to benign or malignant thyroid disease are not uncommon. Patients with TGC should be evaluated for thyroid disease before surgical treatment. While the Sistrunk procedure is the standard surgical technique in the treatment of TGC, in adults, if the cyst terminates below the hyoid bone, total cyst excision without removing the central portion of the hyoid bone may be sufficient., Competing Interests: No conflict of interest was declared by the authors., (© Copyright 2024 by The Medical Bulletin of Sisli Etfal Hospital.)

Thyroglossal duct cysts, which are the most frequently encountered congenital cervical anomalies in children, occur due to embryologic remnants of the thyroglossal duct. Although diagnosis may be challenging, clinicians can be aided by imaging and fine-needle aspiration biopsies. We describe the clinical management of a two-year-old boy with a thyroglossal duct cyst mimicking a goitre on a pertechnetate thyroid scan.

Background: The thyroglossal duct cyst (TDC, also known as the thyroglossal tract remnant, or TTR) is a well-known developmental anomaly that affects roughly 7% of the population. It often manifests as a movable, painless lump. Objectives: To report our 2 years of clinical experience with thyroglossal cysts in terms of clinical aspects and surgical findings. Materials and Methods: This study was conducted in Department of General Surgery, MKCG Medical College and Hospital, Berhampur over a period of 24 months from July 2019-June 2021. Results: In our study, 88% of patients had neck swelling when they arrived. 15.15% of patients exhibited erythema/redness over swelling, and 18.18% felt tenderness. 15.15% of patients at presentation had painful swelling and deglutination. 18.8% of patients reported having experienced recurrent neck swelling in the previous two years, while 12.12 % only had recurring discharge from the midline neck. The majority of cysts (87.87 %) were subhyoid in site, followed by suprahyoid cysts in 6% of cases, suprasternal cysts in 3 %, and over hyoid cysts in 3%. The majority of the cysts (96.96%) were midline; however one was located on the left side. 88.84% patients had a tract that emerged from the cyst and vanished at the superior edge of the hyoid body, whereas 2 patients (6%) had a patent thyroglossal duct that extended from the cyst to the vallecular mucosa. 1 patient (3%) had a fully patent thyroglossal base of the tongue. 2 patients (6%) had completely absent tract. In 31 individuals (93.93%), the patent duct passed beneath the hyoid body, but it passed through or over the hyoid bone in one patient each. The majority (72.72 %) of cysts were between 1.6 and 3 cm in diameter, while 18.18 % were between 0 and 1.5 cm. 66.66% cysts were firm wheras 33.33% were soft. Conclusion: The most typical congenital abnormalities of the cervical region is a thyroglossal duct cyst. The majority of them have a noticeable midline neck swelling that moves with swallowing and deglutination, most common site being subhyoid. [ABSTRACT FROM AUTHOR]

Thyroglossal duct cyst (TDC) is the most common congenital anomaly of the neck. The thyroglossal duct is an embryological structure which connects the base of the tongue to the thyroid gland, which when fails to obliterate results in this anomaly. The incidence of this anomaly is approximately 7%, representing about 75% of the congenital masses of the neck. This cystic lesion is usually mobile and nontender in nature and usually presents with respiratory distress in infants. A lingual TDC is the rarest form of a TDC, and differs from a classical thyroglossal cyst totally in presentation and management. We present here a rare case of 2-month infant presenting with respiratory distress due to lingual TDC extending up to the suprathyroid region.

Objectives: To evaluate the long-term efficacy and safety of ethanol ablation (EA) for the treatment of thyroglossal duct cysts (TGDCs). Methods: This retrospective study included 81 consecutive patients diagnosed with and treated for symptomatic TGDCs at two institutions between Jan 2008 and Oct 2018. Preprocedural evaluation included US assessment with calculation of the TGDC volume. EA was performed under US guidance using 99% ethanol. Post-treatment follow-up was scheduled within 3 months, 6 months, and then annually. Immediate success was defined as a volume reduction ratio (VRR; ratio of the volume difference after EA to the initial TGDC volume) > 50% within 3 months. Long-term success was defined as VRR > 50% or resolution or improvement of cosmetic problems and symptoms without recurrence at last follow-up. Results: Seventy-seven patients underwent EA, and outcomes were assessed in 68 patients with available follow-up data. The immediate success rate of the first EA was 81% (55/68), with a mean VRR within 3 months of 73% ± 31%. One patient (1.5%, 1/68) developed wound inflammation after the first EA. Forty-two patients were followed up for longer than 2 years. For the median follow-up of 69 months (range, 24–131 months), the long-term success rate was 83% (35/42), with a mean VRR at last follow-up of 81% ± 35%. No patients developed malignancy from the ablated TGDCs. Conclusions: EA for treatment of TGDCs achieved acceptable rates of immediate and long-term efficacy with a low complication rate, and can be considered as a first-line treatment for the management of TGDCs. Key Points: • The immediate success rate of EA for the treatment of TGDCs was 81% (55/68), with a mean VRR within 3 months of 73% ± 31%. • For the median follow-up of 69 months (range, 24–131 months), the long-term success rate was 83% (35/42), with a mean VRR at last follow-up of 81% ± 35%. • No patients developed malignancy from the ablated TGDCs but one patient (1.5%, 1/68) developed wound inflammation after the first EA. [ABSTRACT FROM AUTHOR]

Ectopic thyroid tissue can be present in the embryonal path of descent of the thyroglossal duct anywhere from the foramen caecum to the thyroid gland. However, for such ectopic thyroid tissue to be hyperfunctioning is quite rare. Here, we discuss a 56-year-old female patient who presented with persistent thyrotoxicosis for over 7 years. She had undergone thyroidectomy in 1982 for thyrotoxicosis and was rendered hypothyroid (thyroid-stimulating hormone of 75 µlU/mL). Whole-body technetium scan was done twice which did not show any uptake in the neck or other parts of the body and an empirical dose of 15 mCi of radioiodine therapy was also given to treat the thyrotoxicosis. She continued to be thyrotoxic and was on Carbimazole 30 mg/day along with beta-blockers. In 2021, an Iodine131 whole-body scan revealed small remnant thyroid tissue and an ectopic thyroid tissue in a thyroglossal cyst. In such cases of persistent or recurrent thyrotoxicosis despite standard treatments, an ectopic location should be sought after and treated. [ABSTRACT FROM AUTHOR]

Sistrunk procedure is the standard method for thyroglossal duct cyst resection. While this procedure is successful and safe, it results in postoperative scars on the front of neck. We propose a total transoral technique without external incision that starts with careful separation of the floor of the mouth and genioglossus muscle followed by the exact localization of the cyst using methylene blue. Simultaneously, the hyoid bone connected to the cyst and tract was removed. Finally, routine hemostasis is conducted, and the operative cavity is closed. All patients who received this operation in our department recovered successfully without experiencing severe intraoperative or postoperative complications. [ABSTRACT FROM AUTHOR]

Objectives: To review the effectiveness and safety of chemical ablation using ethanol or OK-432 for the treatment of TGDCs (thyroglossal duct cysts). Methods: MEDLINE and EMBASE databases were searched up to May 29, 2020, to identify studies reporting the safety and efficacy of chemical ablation using ethanol or OK-432 for the treatment of TGDCs. The search query consisted of synonyms of thyroglossal duct cysts and ethanol or OK-432 ablation. The pooled success and complication rates were calculated using the inverse variance method to calculate weights, and pooled proportions were determined using the DerSimonian-Laird random-effects method. Results: Seven original articles including a total of 129 patients were included. The efficacy of chemical ablation was acceptable, with a pooled success rate of 70% (95% CI, 47–86%). The pooled success rate of ethanol ablation was superior to that of OK-432 ablation, although with equivocal statistical significance (84% vs. 51%, p = 0.055). Repeat ethanol ablation achieved a pooled success rate of 47% (95% CI, 24–71%). The chemical ablation procedures were safe, with a pooled major complication rate of 0.9% (95% CI, 0.1–5.8%). Conclusions: Chemical ablation using ethanol or OK-432 for the treatment of TGDCs had acceptable success and low complication rates, and repeat treatment after initial failure was also feasible. In addition, it is an inexpensive and simple procedure and could therefore be considered a first-line treatment for TGDCs. Key Points: • The efficacy of chemical ablation using ethanol or OK-432 was acceptable, with a pooled success rate of 70% (95% CI, 47–86%). The pooled success rate of ethanol ablation was superior to that of OK-432 ablation, although with equivocal statistical significance (84% vs. 51%, p = 0.055). • Repeat ethanol ablation was also feasible, with a pooled success rate of 47% (95% CI, 24–71%). • The chemical ablation procedures were safe, with a pooled major complication rate of 0.9% (95% CI, 0.1–5.8%). [ABSTRACT FROM AUTHOR]

Introduction: Thyroglossal duct cyst is amongst the most common congenital anomalies in the neck region which is only properly treated with surgery. However, the long-term result remains uncertain. The present study aimed to assess surgical outcomes and predictors of recurrence in cases of thyroglossal duct cyst that have been referred to a tertiary level children hospital in Iran. Materials and Methods: In this cross-sectional study, 29 children with thyroglossal duct cyst that had undergone Sistrunk procedure in Mofid hospital between 2011 and 2018 were evaluated. The study information was collected by reviewing the hospital charts. Results: Patient's age ranged between 20 and 40 months. The disease in boys was twice as prevalent as girls and hence male to female ratio was almost equal to 2 to 1. Palpable cervical mass was the most prevalent which we found in 62.1%, followed by painful neck mass (13.8%), discharging cutaneous fistula (13.8%), palpable mass with dysphagia (6.9%) and abscess (3.4%). Preoperative antibiotics were prescribed for infection in 34.5%. Regarding the position of the thyroglossal duct cyst, suprahyoid position was reported in 72.4%. In terms of type of surgery, 23 cases (79.3%) underwent sistrunk procedure and 6 cases (20.7%) underwent simple incision. The mean follow-up time for patients was 3.32 ± 1.42 years. The relapse rate after surgery was 6.9% and the rate of postoperative complications was 10.3%. The percentage of relapse-free survival was 91.3% during the follow up period. The presence of discharging fistula as the predominant manifestation (p = 0.009), preoperative infection (p = 0.043), and thyrohyoid position (p = 0.016) were related to the disease recurrence. Conclusion: Surgical complications rate including relapse or infections was 10.3% and the incidence of recurrence after surgery during the follow-up period with a mean of three years was 6.9%; that is more prevalent in patients with the presence of discharging fistula, preoperative infection, or thyrohyoid position. Preoperative infections, rather than postoperative infections, are associated with more recurrence. Thus infection is very important factor in the recurrence of thyroglossal duct cyst.

Sistrunk procedure is the standard method for thyroglossal duct cyst resection. While this procedure is successful and safe, it results in postoperative scars on the front of neck. We propose a total transoral technique without external incision that starts with careful separation of the floor of the mouth and genioglossus muscle followed by the exact localization of the cyst using methylene blue. Simultaneously, the hyoid bone connected to the cyst and tract was removed. Finally, routine hemostasis is conducted, and the operative cavity is closed. All patients who received this operation in our department recovered successfully without experiencing severe intraoperative or postoperative complications.

Thyroglossal duct cyst (TDC) is the most common congenital anomaly of the neck. The thyroglossal duct is an embryological structure which connects the base of the tongue to the thyroid gland, which when fails to obliterate results in this anomaly. The incidence of this anomaly is approximately 7%, representing about 75% of the congenital masses of the neck. This cystic lesion is usually mobile and nontender in nature and usually presents with respiratory distress in infants. A lingual TDC is the rarest form of a TDC, and differs from a classical thyroglossal cyst totally in presentation and management. We present here a rare case of 2-month infant presenting with respiratory distress due to lingual TDC extending up to the suprathyroid region. [ABSTRACT FROM AUTHOR]

Thyroglossal duct cysts, which are the most frequently encountered congenital cervical anomalies in children, occur due to embryologic remnants of the thyroglossal duct. Although diagnosis may be challenging, clinicians can be aided by imaging and fine-needle aspiration biopsies. We describe the clinical management of a two-year-old boy with a thyroglossal duct cyst mimicking a goitre on a pertechnetate thyroid scan. [ABSTRACT FROM AUTHOR]

Papillary carcinoma of the thyroglossal cyst is clinically like the benign lesion in adults aged 15-45 year, with a higher incidence in females. It is a congenital anomaly of the midline of the neck and have the clinical worsening related to infections of high aerodigestive routes. We discuss clinical assess, diagnosis, surgery, hormonal suppression, radioiodine therapy, and prognosis in a patient with a complaint of nodule in the neck, and to the ultrasonography an image suggestive of the thyroglossal cyst without alteration of thyroid gland. He was submitted to Sistrunk’s surgery and the anatomopathological exam revealed papillary carcinoma, and we do not find normal thyroid follicles in the thyroglossal cyst wall. We perform the total thyroidectomy by the thyroid alterations, showing in the anatomopathological exam a thyroid microcarcinoma. We completed by hormonal suppression and radioiodine therapy. The prognosis is favorable and the patient presented asymptomatic until now.

Thyroglossal cyst is the most common congenital neck anomaly in children with equal sex incidence, but papillary carcinoma of the thyroglossal cyst in children is rare with only 10 cases reported so far. Even in adults, the incidence of malignancy in the thyroglossal cyst is only 1%. Most cases are diagnosed following surgery on histopathological examination; there is no consensus on the management owing to this rarity and indolent but unpredictable behavior of thyroid cancers. Here, we present one such rare case.

Introduction. Thyroglossal cyst represents the most common congenital anomaly of the neck and it occurs in approximately 7% of the overall population. It develops as a consequence of obliteration failure of ductus thyreoglossus during migration of thyroid gland in embryogenesis. It is usually diagnosed during the first decade of life by clinical examination, echosonography, multislice computed tomography (MSCT) and/or magnetic resonance imagining (MRI) of the brain and neck, fine needle aspiration (FNA) and cytological analysis of the FNA content. Treatment is surgical using the Sistrunk procedure. Case report. The 40 year-old patient was hospitalized for the diagnostics and treatment of the tumor of submental and submandibular region as well as of oral cavity, with right-sided dislocation of the tongue followed by difficulties in swallowing and speech. In his early childhood, the patient detected a subcutaneous formation under the chin that expanded gradually. Clinical examination revealed the subcutaneous tumor mass that affected submental and both submandibular regions, predominantly left-sided with the intraoral presentation of submucosal tumor that completely filled oropharynx and dislocated the tongue to the right side. MSCT of the mouth and neck floor indicated an irregularly oval tumor of 120 x 95 x 90 mm, with its upper pole reaching the hard palate. The tumor filled the oral cavity and descended anterolaterally and more to the left side into the neck region to the hyoid bone, dislocating the tongue, eosophagus as well as pharyngeal and laryngeal structures to the right side. Cytological analysis of the FNA content confirmed the presence of thyroglossal cyst. Under nasotracheal intubation, the operation using the Sistrunk procedure was performed, with the removal of cystic tumor, and medial portion of hyoid bone, as well as with the tongue reposition. There were no complications during post-operative period. Speech and swallowing functions were completely rehabilitated. The results of pathohistological analysis confirmed the presence of thyroglossal cyst. Conclusion.Thyroglossal cysts are the most common congenital anomalies of the neck and the treatment is surgical with satisfying outcome, low complication rates and small percentage of recidives.

A 23-year-old young man presented with a painless neck mass that he noticed slowly growing over the past 4 years. Neck imaging showed an irregular 5 x 5 cm mixed solid and cystic mass in mid neck that looked suspicious but normal looking thyroid and no neck lymphadenopathy. Thyroid uptake scan was within normal also. Fine needle biopsy (FNA) from thyroglossal cyst (TGC) was malignant, Bethesda VI. Multi-disciplinary meeting discussed the case and advised for removal of both the TGC cancer and total thyroidectomy. After patient counseling, he underwent Sistrunk procedure for excision of the TGC mass and total thyroidectomy. histopathological examination revealed a poorly differentiated carcinoma of insular type in TGC with unremarkable thyroid gland. Patient recovery was uneventful. Post-operative multi-disciplinary meeting discussed the histopathology results and advised for post-operative radioactive iodine therapy (RAI) and thyroxine suppression followed by serum thyroid stimulating hormone (TSH) and thyroglobulin (TG). We shall review the diagnostic and management considerations of our case having this rare cancer [ABSTRACT FROM AUTHOR]

BackgroundGeneral surgery (GS) residents in ACGME programs log cases performed during their residency. We reviewed designated pediatric surgery (PS) cases to assess for changes in performed cases over time.MethodsThe ACGME case logs for graduating GS residents were reviewed from academic year (AY) 1989-1990 to 2010-2011 for designated pediatric cases. Overall and designated PS cases were analyzed. Data were combined into five blocks: Period I (AY1989-90 to AY1993-94), Period II (AY1994-95 to AY1998-99), Period III (AY1999-00 to AY2002-03), Period IV (AY2003-04 to AY2006-07), and Period V (AY2007-08 to AY2010-11). Periods IV and V were delineated by implementation of duty hour restrictions. Student t-tests compared averages among the time periods with significance at P < .05.ResultsOverall GS case load remained relatively stable. Of total cases, PS cases accounted for 5.4% in Period I and 3.7% in Period V. Designated pediatric cases declined for each period from an average of 47.7 in Period I to 33.8 in Period V. These changes are due to a decline in hernia repairs, which account for half of cases. All other cases contributed only minimally to the pediatric cases. The only laparoscopic cases in the database were anti-reflux procedures, which increased over time.ConclusionsGS residents perform a diminishing number of designated PS cases. This decline occurred before the onset of work-hour restrictions. These changes have implications on the capabilities of the current graduating workforce. However, the case log does not reflect all cases trainees may be exposed to, so revision of this list is recommended.

Congenital midline cervical cleft is a rare congenital disease. The disease is often misdiagnosed as a branchial cleft deformity, thyroglossal duct cyst, or other skin diseases. It has the following characteristics: skin defect at the midline of the anterior neck, a skin tag at the upper end of the lesion, and a blind sinus tract at the caudal aspect with or without mucoid discharge. Treatment is usually for aesthetic purposes; therefore, early surgical en bloc resection with Z-plasty or W-plasty is recommended to reduce recurrence and scar formation. [ABSTRACT FROM AUTHOR]

Carcinoma arising in a thyroglossal cyst is rare. We present a case of anterior neck swelling diagnosed to be thyroglossal cyst clinically which turns out to be a papillary carcinoma arising in thyroglossal cyst. She underwent sistrunk procedure with total thyroidectomy and diseasefree on follow up evaluation. Even though preoperative ultrasonography had shown thyroid nodule, the final histology did not show malignancy. There is a paucity of clear-cut guidelines in the management of the thyroid gland in a thyroglossal cyst carcinoma. In thyroglossal cyst carcinoma cases, we recommend thyroidectomy only when there is a thyroid nodule with high-risk features.

Head and neck masses can present in different pathologies that usually vary according to the age of the patient. We report five cases of benign head or neck masses occurring among patients of different ages who were managed at the Bahrain Defence Force Royal Medical Services Hospital, Ar-Rifaa, Bahrain, between 2005–2014. All of the patients were treated using the sclerotherapeutic agent OK-432. Although surgical removal is usually considered optimal treatment in the management of such cases, OK-432 appears to be a promising alternative.

Purpose The purpose of this study was to identify ultrasonographic features that can be used to differentiate between thyroglossal duct cysts (TGDCs) and dermoid cysts (DCs). Methods We searched surgical pathology reports completed between January 2004 and October 2015 and identified 66 patients with TGDCs or DCs who had undergone preoperative ultrasonography. The ultrasound images were reviewed by two radiologists who were blinded to the pathological diagnosis. They evaluated the following parameters: dimensions, shape, margin, location in relation to the midline, level in relation to the hyoid bone, attachment to the hyoid bone, the depth of the lesion in relation to the strap muscles, internal echogenicity, internal echogenic dots, multilocularity, the presence of a longitudinal extension into the tongue base, posterior acoustic enhancement, the presence of internal septae, and intralesional vascularity. Results There were 50 TGDCs and 16 DCs. TGDCs were significantly more likely than DCs to have an irregular shape, an ill-defined margin, attachment to the hyoid bone, an intramuscular location, heterogeneous internal echogenicity, multilocularity, and longitudinal extension into the tongue base. Conclusion Ultrasound findings may inform the differential diagnosis between TGDCs and DCs.

Ectopic thyroid tissue is rare, with a reported incidence of 1 in 300,000. A thyroglossal duct cyst is the most common developmental anomaly of the thyroid gland. The probability of carcinoma arising in such tissue is <1%. The incidence of papillary carcinoma of the thyroid is more in 30-50 years. Here, we report a case of an 18-year-old female presenting with anterior neck swelling, found to have a thyroglossal cyst, fine-needle aspiration cytology (FNAC) of which showed a cystic mass with sparse epithelial cells. After the Sistrunk surgery, biopsy showed classic papillary carcinoma of the thyroid. She underwent total thyroidectomy followed by thyroxine replacement. Thyroglossal cyst papillary carcinoma of the thyroid is a rare entity in young whose diagnosis is easily missed on FNAC; a thorough examination of the biopsy specimen is required. Management should be considered based on multiple associated factors. Overall, the prognosis of it is very good, with a 5-year survival rate of 95%. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course Background: Thyroglossal duct cysts are the most common congenital neck cysts. They typically present in childhood and early adulthood, and average a size of 2-4 cm, but can also present in later adult life. Case Report: We present a case of a 36-year-old female patient with a very large midline neck mass, reaching the mandible superiorly. Patient history and physical examination, as well as computed tomography scan of her neck, confirmed the diagnosis of large thyroglossal duct cyst. She underwent Sistrunk procedure for thyroglossal duct cyst excision, and the specimen was sent for histopathological evaluation, which confirmed the diagnosis. Conclusions: Thyroglossal duct cyst should be considered as a differential diagnosis in older patients and in patients with a relatively large neck mass. [ABSTRACT FROM AUTHOR]

Thyroglossal duct cyst is a common congenital anomaly, due to failure of embryological development. Whenever diagnosed, surgical excision of the cyst is indicated due to the risk of infection and malignancy, with papillary thyroid carcinoma being the most common. This paper reports the case of a young patient who presented mass in the anterior cervical region, whose anatomopathological confirmed the diagnosis of thyroglossal duct cyst carcinoma with ectopic thyroid tissue, without evidence of carcinoma in the thyroid gland. Work carried out by reviewing the medical chart, and then analysis and discussion based on current literature. This article aimed to reinforce the importance of conducting an anatomopathological study of the thyroglossal duct cysts and the differentiation of metastatic carcinomas and primary carcinomas. [ABSTRACT FROM AUTHOR]