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Pupić-Bakrač J, Jayasekara S, Peiris PM, Jayasinghe LAH, Kapugama K, Jayasuriya NSS, Wijekoon P, Attygalla M. Malignancy and "Violated Neck" Rates in Consecutive Cohort of 79 Adult Patients With Solitary Cystic Neck Mass-Lessons Learned and Recommendations for Clinical Practice Guidelines. J Craniofac Surg 2024; 35:e380-e385. [PMID: 38651860 DOI: 10.1097/scs.0000000000010122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/12/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVE The neck region is a common site for solitary cystic neck mass (SCNM) of various etiologies, including congenital, inflammatory, and neoplastic. In adults, the primary focus is excluding malignancy. The objective of this study was to retrospectively analyze the accuracy of available diagnostic technologies for the differentiation of benign and malignant SCNM in adult patients. The study aimed to develop new clinical practice guidelines for evaluating and managing SCNM. METHODS The primary predictive variables were the diagnostic utilities of fine-needle aspiration cytology (FNAC), ultrasound (U/S), multislice computed tomography, and magnetic resonance imaging. The study's endpoint was the overall diagnostic accuracy in differentiating between benign and malignant SCNM. The final diagnosis was based on histopathology. RESULTS The study included 79 adult patients: 55 (69.62%) male and 24 (30.38%) female ( P <0.05). The mean age at presentation was 42.1 years (range: 18-84 years). Solitary cystic neck mass was distributed in the anterior neck region in 30 (37.97%) patients and the posterolateral neck regions in 49 (62.03%) patients ( P <0.05). The posterolateral neck regions had a significantly higher rate of malignant SCNM than the anterior neck region [19/49 (38.78%) versus 1/30 (3.33%)] ( P <0.05). There was no statistically significant difference between the U/S+FNAC and U/S+FNAC+multislice computed tomography and/or magnetic resonance imaging groups in differentiating benign and malignant SCNM (40/42 versus 36/37, P >0.05). "Violated neck" was recorded in 2 cases. CONCLUSION A systematic investigation protocol should be applied to evaluate adult patients with SCNM.
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Affiliation(s)
- Jure Pupić-Bakrač
- Department of Otorhinolaryngology and Maxillofacial Surgery, General Hospital Zadar, Zadar, Croatia
| | - Sandeep Jayasekara
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Prasangi M Peiris
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Kanchana Kapugama
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Nadeena S S Jayasuriya
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Parakrama Wijekoon
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Manjula Attygalla
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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Houas J, Ghammam M, Laabidi E, Khalfi O, Bellakhdher M, Abdelkefi M. Malignant degeneration of thyroglossal duct cysts: Clinical aspects, imaging findings and management: Case series. Int J Surg Case Rep 2024; 115:109325. [PMID: 38301307 PMCID: PMC10847149 DOI: 10.1016/j.ijscr.2024.109325] [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: 12/28/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Thyroglossal duct cysts (TDCs) are congenital anomalies that can rarely undergo malignant transformation, with approximately 1 % of operated TDCs demonstrating malignant degeneration. Therapeutic management and follow-up methods are still controversial subjects. CASE SERIES PRESENTATION We report 3 cases of a papillary carcinoma of thyroid occurring in a thyroglossal duct cyst. The diagnosis was suspected preoperatively in 2 patients, hence the indication of frozen section examination. All patients underwent Sistrunk procedure associated with total thyroidectomy and central neck dissection. Concomitant papillary thyroid carcinoma was found in 2 patients. A complementary treatment by radioactive iodine 131 with frenetic hormone therapy was undertaken in all the cases. The follow-up showed no recurrence. CLINICAL DISCUSSION The clinical presentation of thyroglossal duct cyst carcinoma is often nonspecific, posing challenges in early diagnosis. The chosen treatment strategy, involving the Sistrunk procedure, total thyroidectomy, and central neck dissection, along with adjuvant therapy using radioactive iodine 131 and frenetic hormone therapy, was effective in preventing recurrence. CONCLUSION The management of degenerated TDC is based on a multidisciplinary approach. Papillary carcinomas of TDC generally have a good prognosis.
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Affiliation(s)
- Jihene Houas
- University of Sousse Faculty of Medicine of Sousse, ENT Department, Farhat Hached University Hospital, Sousse, Tunisia.
| | - Monia Ghammam
- University of Sousse Faculty of Medicine of Sousse, ENT Department, Farhat Hached University Hospital, Sousse, Tunisia
| | - Eya Laabidi
- University of Sousse Faculty of Medicine of Sousse, ENT Department, Farhat Hached University Hospital, Sousse, Tunisia
| | | | - Mouna Bellakhdher
- University of Sousse Faculty of Medicine of Sousse, ENT Department, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Abdelkefi
- University of Sousse Faculty of Medicine of Sousse, ENT Department, Farhat Hached University Hospital, Sousse, Tunisia
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Lee JPH, Saniasiaya J. An Unexpected Midline Neck Swelling in a Young Female. Oman Med J 2024; 39:e601. [PMID: 38370333 PMCID: PMC10874495 DOI: 10.5001/omj.2024.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/24/2023] [Indexed: 02/20/2024] Open
Affiliation(s)
| | - Jeyasakthy Saniasiaya
- Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Jalan Universiti, Kuala Lumpur, Malaysia
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Yankov YG, Stoev L, Dimanov S, Stoeva M, Stanislavova K. A Rare Case of Papillary Thyroid Carcinoma in the Thyroglossal Duct Cyst of a 14-Year-Old Female Patient With Left Thyroid Hemiagenesis. Cureus 2023; 15:e49712. [PMID: 38161947 PMCID: PMC10757459 DOI: 10.7759/cureus.49712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Congenital abnormalities in the development of the thyroglossal duct are a common pathology in the pediatric population. The exact frequency of hemiagenesis of the thyroid gland is not known because the condition is rarely manifested clinically and is almost always discovered incidentally. Papillary carcinoma of thyroglossal cysts is relatively uncommon, has a good prognosis if promptly detected and treated and occurs mainly in adults. The case we present here is an extremely rare occurrence: a patient with papillary thyroid carcinoma of the thyroglossal duct cyst and thyroglossal duct cyst carcinoma (TDCa). So far, only two such adult patients (women aged 24 and 35) have been described in the world medical literature. The patient we present is a 14-year-old female and is the first described adolescent with papillary carcinoma of the thyroglossal duct cyst and thyroid hemiagenesis (THA). The disease didn't have any clinical manifestations, and the patient was brought in by her parents to improve her aesthetic appearance. Neither the physical examination nor the radiological evaluation showed any signs of malignancy. The diagnosis was reached by our team only after the patoanatomical examination. In this patient's case, due to its early diagnosis, the spread of the disease was limited only to the borders of the thyroglossal duct cyst and the absence of regional and distant metastasis. Surgical removal led to a complete cure, without any postoperative data suggestive of residual disease. The functions of the thyroid gland in her case were not affected, despite her left-lobe agenesis, to which there are multiple proofs, namely the normal blood concentration of the examined thyroid markers: free triiodothyronine (FT3), free thyroxine (FT4), thyroglobulin (TG), thyroid stimulating hormone (TSH), anti-TG (thyroid antibody test (TAT)), anti-thyroid peroxidase (TPO) (microsomal antibody test (MAT)), and normal physical and psychological development.
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Affiliation(s)
- Yanko G Yankov
- Maxillofacial Surgery, University Hospital St. Marina, Varna, BGR
- General and Operative Surgery, Medical University of Varna, Varna, BGR
| | - Lyuben Stoev
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
| | | | - Martina Stoeva
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
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Sen S, Thomas SS, Cherian A, Abraham D, Hepzhibah J, John R, Therese M, Reka K, Paul MJ. Thyroglossal Duct Cyst Carcinoma: Lessons from a 20-Case Series. Indian J Surg Oncol 2023; 14:609-618. [PMID: 37900628 PMCID: PMC10611691 DOI: 10.1007/s13193-023-01720-0] [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: 07/29/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Aims and Objectives Thyroglossal duct cyst (TDC) is a common congenital cyst with an incidence of about 7%. Thyroglossal duct cyst carcinoma (TDCC) is a rare sequel which arises from TDC and has an incidence of about 1%. As these are rare, they do not have well-defined management guidelines. The aim of this study was to analyse the clinical profile and pathological characteristics of patients with thyroglossal duct cyst carcinoma and to propose a protocol for their treatment and follow-up. Materials and Methods A retrospective study was done from January 2000 to December 2019. All the clinical details, imaging characteristics, treatment and histopathology were analysed. Results The mean age group in our study was 37.9 years with a female preponderance. The clinical features like rapid increase in size, fixity of the lump and lymph node metastasis were not very common. Seventy-five percent of our patients who underwent imaging had suspicious characteristics. Fifty-six percent of our patients had FNAC suggestive of TDCC. Fifty percent of our patients had concomitant thyroid carcinoma. None of our patients had distant metastasis at follow-up. Conclusions TDCC is rare and a disease of young adulthood and usually has good prognosis. It may be a clinical surprise or a small lesion which can be detected with ultrasound and targeted FNAC. There is high rate of concomitant thyroid carcinoma and hence needs careful assessment. Sistrunk's procedure with total thyroidectomy either staged or simultaneously has good outcome and permits adjuvant treatment.
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Affiliation(s)
- Supriya Sen
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Shawn Sam Thomas
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Anish Cherian
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Deepak Abraham
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Julie Hepzhibah
- Department of Nuclear Medicine, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Reetu John
- Department of Radiology, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Marie Therese
- Department of Pathology, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - K. Reka
- Department of Biostatistics, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - M. J. Paul
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
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Ahn D. Ultrasound-Guided Ethanol Ablation for Thyroglossal Duct Cyst: A Review of Technical Issues and Potential as a New Standard Treatment. J Clin Med 2023; 12:5445. [PMID: 37685512 PMCID: PMC10487699 DOI: 10.3390/jcm12175445] [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: 07/24/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
The thyroglossal duct cyst (TGDC) is the most common congenital neck mass, accounting for 70-75% of all congenital neck masses. Although the Sistrunk operation has been used as a standard of treatment, it is accompanied by a considerable surgical burden, including the need for general anesthesia, a visible surgical scar on the neck surface, and postoperative complications. Ultrasound-guided ethanol ablation (US-EA) is a minimally invasive and office-based technique that is widely used as a non-surgical treatment for several benign cystic lesions, particularly benign thyroid cysts. Recently, US-EA has also been gaining popularity as a good alternative for TGDC treatment, which is associated with high feasibility, a high safety profile, and favorable treatment outcomes. To our best knowledge, seven studies on the use of EA as a primary treatment option for TGDC have been published since 2011. Although these studies have reported promising results, there is a lack of consensus on several issues regarding the application of EA for TGDC, particularly its detailed techniques and role as a primary treatment. This article aims to provide a comprehensive review of EA for TGDC, addressing technical issues and its possible role as a new standard of treatment for TGDC.
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Affiliation(s)
- Dongbin Ahn
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Republic of Korea
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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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8
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Pandiar D, Nayanar SK, Nair V. Papillary thyroid carcinoma arising in thyroglossal duct cyst: A case report with long term follow-up. Oral Oncol 2023; 143:106439. [PMID: 37290382 DOI: 10.1016/j.oraloncology.2023.106439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/10/2023]
Affiliation(s)
- Deepak Pandiar
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India.
| | - Sangeetha K Nayanar
- Department of Clinical Laboratory Services & Translational Research, Malabar Cancer Center, Thalassery, Kerala, India.
| | - Vivek Nair
- Department of Clinical Laboratory Services & Translational Research, Malabar Cancer Center, Thalassery, Kerala, India.
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Ahn D, Kwak JH, Lee GJ, Sohn JH. Ultrasound-Guided Ethanol Ablation as a Primary Treatment for Thyroglossal Duct Cyst: Feasibility, Characteristics, and Outcomes. Otolaryngol Head Neck Surg 2023; 168:1381-1388. [PMID: 36939631 DOI: 10.1002/ohn.231] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/11/2022] [Accepted: 11/28/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To evaluate the feasibility, characteristics, and outcomes of ultrasound-guided ethanol ablation (US-EA) as a primary treatment for thyroglossal duct cysts (TGDCs). STUDY DESIGN Prospective case series. SETTING Single center study. METHODS The inclusion criteria were as follows: (i) patients with TGDC aged ≥18 years, (ii) benign TGDC in imaging and cytological examinations, and (iii) patients' need for nonsurgical scarless treatment. US-EA was used as the primary treatment strategy. The primary outcome variables were the volume reduction rate (VRR) and cosmetic score at the last follow-up. RESULTS We enrolled 28 patients with TGDC. The median TGDC volume at baseline was 6.7 mL. The median procedure time of the US-EA was 6.5 minutes. The median volumes of the cyst aspirate and injected ethanol were 4.0 and 2.0 mL, respectively. Overall, 18, 8, and 2 patients underwent 1, 2, and 3 treatment sessions, respectively. There were no complications. The median VRR was 96.2%, and the treatment success rate was 96.4%. The World Health Organization cosmetic score decreased from 4 (baseline) to 1 (after treatment) in all patients. The subjective grade for cosmetic satisfaction was satisfactory or highly satisfactory in all patients. The VRR, treatment success rate, and the number of treatment sessions did not differ as functions of the characteristics of the TGDC, including the initial volume, septation, debris, or viscosity of the cyst fluid. CONCLUSION US-EA was feasible, safe, and effective in patients with TGDC. Therefore, US-EA can be used as a primary treatment for TGDC, evading general anesthesia and surgical scar.
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Affiliation(s)
- Dongbin Ahn
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Ji Hye Kwak
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Gil Joon Lee
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jin Ho Sohn
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
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Two-centre experience in the treatment of thyroglossal duct remnants using the modified muscle-sparing Sistrunk technique. Int J Oral Maxillofac Surg 2023:S0901-5027(23)00019-X. [PMID: 36764864 DOI: 10.1016/j.ijom.2023.01.018] [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: 11/04/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 02/10/2023]
Abstract
The Sistrunk procedure has long been the method of choice for treating patients with thyroglossal duct remnants (TDRs). However, the extent of the surgical resection in the suprahyoid segment of the TDR remains controversial, as this anatomical site is the origin of both disease recurrence and surgical morbidity. The aim of this two-centre retrospective cohort study was to investigate the outcomes of a modified muscle-sparing Sistrunk procedure in primary TDRs. The primary predictor was the surgical approach, and the outcome variable was the recurrence rate. A total of 110 consecutive patients (62 (56.4%) male, 48 (43.6%) female) who underwent a modified muscle-sparing Sistrunk procedure were included in the study. Their mean age at presentation was 26.9 ± 18.9 years. A modified muscle-sparing Sistrunk procedure using cold instruments, electrocautery, and a harmonic scalpel was performed in all patients. Recurrence was recorded in six (5.5%) patients. The median hospital stay was 2 days (range 1-7 days), and the median follow-up duration was 7 years (range 2-13 years). There was no significant difference in recurrence rate between the conventional and modified muscle-sparing Sistrunk procedure in primary TDRs. The study findings showed that the modified muscle-sparing Sistrunk procedure had low recurrence and complication rates in the context of primary TDR.
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Devaraja K, Malapure SS, Neeraj R, Chandrappa DH. Synchronous carcinoma of thyroglossal duct cyst and native thyroid gland. BMJ Case Rep 2022; 15:e250853. [PMID: 36423942 PMCID: PMC9693668 DOI: 10.1136/bcr-2022-250853] [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] [Indexed: 11/25/2022] Open
Abstract
The unobliterated portion of embryological thyroglossal duct may present as cystic swelling later in life and may contain functional thyroid follicles. This cyst requires excision along with the entire thyroglossal duct remnant and adjacent portion of hyoid bone. At times, the excised specimen could demonstrate a focus of carcinomatous change inside the cyst wall. Very rarely, this thyroglossal duct cyst carcinoma could be associated with malignancy of native thyroid gland. This case report illustrates an interesting case of synchronous carcinoma of thyroglossal duct cyst and native thyroid gland. It also sheds light on the controversies related to the pathophysiology of such association and the dilemmas surrounding the management of thyroglossal duct cyst carcinoma, with or without concurrent carcinoma of thyroid gland.
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Affiliation(s)
- K Devaraja
- Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sumeet Suresh Malapure
- Division of Nuclear Medicine, Radiotherapy, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - R Neeraj
- Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Rossi ED, Tralongo P, Fiorentino V, Curatolo M, Bruno C, De Crea C, Raffaelli M, Pontecorvi A, Larocca LM. Approach to FNA of Thyroid Gland Cysts. Adv Anat Pathol 2022; 29:358-364. [PMID: 35918293 DOI: 10.1097/pap.0000000000000357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Fine needle aspiration is a well-known procedure for the diagnosis and management of thyroid lesions, representing the first diagnostic tool for the definition of their nature. In clinical practice, a thyroid nodule can be classified as solid, cystic, and partially cystic based on its internal components. Different thyroid imaging reporting systems and cytologic diagnostic systems have focused their attention on solid nodules, which are more frequently linked with a malignant outcome. In fact, numerous papers demonstrated that nodules with microcalcifications, a taller-than-wide shape, hypoechogeneity, and irregular margins, are more likely to be malignant on histology. Nevertheless, according to the literature, the risk of malignancy in a partially cystic thyroid nodule ranges between 3.3 and 17-5%, including, for instance, the possible diagnosis of a cystic papillary thyroid carcinoma and other malignant entities. Therefore, in the current review article, we are going to discuss the approach to thyroid cystic lesions on fine needle aspiration cytology.
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Affiliation(s)
| | | | | | | | | | - Carmen De Crea
- Division of Endocrine-Surgery-Fondazione Policlinico Universitario"Agostino Gemelli"-IRCCS, Rome Italy Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
| | - Marco Raffaelli
- Division of Endocrine-Surgery-Fondazione Policlinico Universitario"Agostino Gemelli"-IRCCS, Rome Italy Fondazione Policlinico Universitario "Agostino Gemelli"-IRCCS, Rome, Italy
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Themeli Y, Sinaj E, Hysa E, Nakuci D, Alimehmeti M, Sakellariou G. Papillary Carcinoma in Thyroglossal Duct Cyst and Thyroid Gland with Hashimoto. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.11000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The ectopic thyroid gland is a rare condition. In most cases, ectopic thyroid tissue is the only functioning thyroid tissue, but it may rarely be associated with a normal thyroid gland. Ectopic thyroid carcinoma within a thyroglossal duct cyst is a very rare entity, with controversial individual approaches. This encouraged us to present the case of a 31-year- old woman, with papillary thyroid carcinoma in the thyroid gland and in the thyroid ectopic tissue within the thyroglossal duct. After suspicion of thyroid malignancy in the ultrasonography of the neck, FNA-biopsy was performed on the thyroid nodule and the thyroglossal duct cyst. Since the pathological exam revealed a papillary carcinoma in the eutopic and ectopic thyroid tissues, the Sistrunk procedure and total thyroidectomy were done, followed by radioiodine ablation.
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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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15
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Kim JM, Park KW, Kim DH, Lee DH. Thyroglossal Duct Cyst in the Suprasternal Region. EAR, NOSE & THROAT JOURNAL 2022:1455613221086037. [PMID: 35324319 DOI: 10.1177/01455613221086037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- Jong Min Kim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and 65722Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Keon Woo Park
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and 65722Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Do Hyung Kim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and 65722Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and 65722Chonnam National University Hospital, Gwangju, Republic of Korea
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16
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Hernandez-Prera JC. Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: The Neck and Lymph Nodes, Metastasis, and Melanocytic Tumors. Head Neck Pathol 2022; 16:110-122. [PMID: 35312983 PMCID: PMC9018916 DOI: 10.1007/s12105-022-01433-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/12/2022] [Indexed: 11/26/2022]
Abstract
The changes made in the fifth edition of the WHO Classification of Head and Neck Tumors demonstrate the recent diagnostic, histopathological, and molecular advances in the field, and this updated information will hopefully lead to improved and standardized tumor subtyping. This review summarizes the changes related tumors and tumor-like lesions of the neck and lymph nodes (Chapter 11), metastasis to the head and neck region (Chapter 15), and melanocytic tumors (Chapter 10).
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Affiliation(s)
- Juan C Hernandez-Prera
- Department of Pathology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
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17
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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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18
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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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19
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Jonsson B, Madhok M. Child With Neck Lesion. J Emerg Med 2021; 61:186-188. [PMID: 34001420 DOI: 10.1016/j.jemermed.2021.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/12/2021] [Accepted: 02/19/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Bergthor Jonsson
- Department of Emergency Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Manu Madhok
- Pediatric Emergency Medicine, Children's Minnesota, Minneapolis, Minnesota
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20
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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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21
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Blaseg NA, Munson PD. Papillary thyroid carcinoma arising in a thyroglossal duct cyst in a pediatric patient. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.101790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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22
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Case report: Thyroglossal duct cyst papillary carcinoma in a young male. ANNALES D'ENDOCRINOLOGIE 2021; 82:126-128. [PMID: 33636183 DOI: 10.1016/j.ando.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 11/22/2022]
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23
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Frauenfelder C, Shelmerdine SC, Simcock IC, Hall A, Hutchinson JC, Ashworth MT, Arthurs OJ, Butler CR. Micro-CT Imaging of Pediatric Thyroglossal Duct Cysts: A Prospective Case Series. Front Pediatr 2021; 9:746010. [PMID: 34557462 PMCID: PMC8453197 DOI: 10.3389/fped.2021.746010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/16/2021] [Indexed: 12/18/2022] Open
Abstract
Objectives: To determine the feasibility of micro-CT as a high-resolution 3D imaging tool for thyroglossal duct cysts and to evaluate its role augmenting traditional histopathological examination of resected specimens. Methods: A single centre, prospective case series of consecutive children undergoing excision of a thyroglossal duct cyst was performed at a quaternary paediatric referral hospital in the United Kingdom. Consecutive children listed for excision of a thyroglossal duct cyst whose parents agreed to participate were included and there were no exclusion criteria. Results: Surgically excised thyroglossal duct cyst or remnant specimens from five patients (two males, three females) were examined using micro-CT alongside traditional histopathological examination. In all cases, micro-CT imaging was able to demonstrate 3D imaging datasets of the specimens successfully and direct radio-pathological comparisons were made (Figures 1-5, Supplementary Video 1). Conclusions: The study has shown the feasibility and utility of post-operative micro-CT imaging of thyroglossal duct cysts specimens as a visual aid to traditional histopathological examination. It better informs the pathological specimen sectioning using multi-planar reconstruction and volume rendering tools without tissue destruction. In the complex, often arborised relationship between a thyroglossal duct cyst and the hyoid, micro-CT provides valuable image plane orientation and indicates proximity of the duct to the surgical margins. This is the first case series to explore the use of micro-CT imaging for pediatric thyroglossal duct specimens and it informs future work investigating the generalizability of micro-CT imaging methods for other lesions, particularly those from the head and neck region where precisely defining margins of excision may be challenging.
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Affiliation(s)
- Claire Frauenfelder
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.,Discipline of Surgery, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Susan C Shelmerdine
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.,UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, United Kingdom.,National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre, London, United Kingdom
| | - Ian C Simcock
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.,UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, United Kingdom.,National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre, London, United Kingdom
| | - Andrew Hall
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - John Ciaran Hutchinson
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.,UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, United Kingdom.,National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre, London, United Kingdom.,Department of Histopathology, St Thomas' Hospital, London, United Kingdom
| | - Michael T Ashworth
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Owen J Arthurs
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.,UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, United Kingdom.,National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre, London, United Kingdom
| | - Colin R Butler
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.,UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, United Kingdom
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24
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Barbieri A, Prasad ML, Gilani SM. Thyroid tissue outside the thyroid gland: Differential diagnosis and associated diagnostic challenges. Ann Diagn Pathol 2020; 48:151584. [PMID: 32871503 DOI: 10.1016/j.anndiagpath.2020.151584] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022]
Abstract
The presence of thyroid tissue outside of the thyroid gland may occur in various clinical settings and anatomic locations and includes both benign and malignant differential diagnoses. Some of these entities include thyroglossal duct cyst, lingual thyroid, parasitic nodule, thyroid tissue within a lymph node and struma ovarii. In routine daily practice, these entities do pose diagnostic challenges for the pathologists. Differential diagnostic considerations depend largely on the location of lesion and the histologic features. A definitive diagnosis may remain unclear in some cases while knowledge is still evolving in others i.e., incidentally detected bland appearing thyroid follicles in a lateral neck lymph node. This article aims to elaborate on the various entities characterized by thyroid tissue outside of the thyroid gland, both benign and malignant, and the relevant differential diagnostic considerations.
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Affiliation(s)
- Andrea Barbieri
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Manju L Prasad
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Syed M Gilani
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA.
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25
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Byard RW. Airway compromise and thyroglossal duct cysts in adulthood. Forensic Sci Med Pathol 2020; 17:139-140. [PMID: 32623656 DOI: 10.1007/s12024-020-00280-x] [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] [Accepted: 06/18/2020] [Indexed: 11/26/2022]
Abstract
A 61-year-old man died suddenly after a brief history of shortness of breath and hemoptysis. At autopsy he had lobar pneumonia involving the right upper and left lower lobes of the lung. Significantly there was also a 30 × 20 mm (in cross-section) thyroglossal duct cyst compressing the upper airway. Death was attributed to respiratory failure due to the combined effects of lobar pneumonia (cultures positive for Streptococcus pneumoniae) and airway narrowing from a thyroglossal duct cyst. Although such cysts are usually found in childhood they may on occasion be diagnosed in adults. Despite being the most common congenital cyst in the neck cases associated with a lethal outcome are extremely rare.
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Affiliation(s)
- Roger W Byard
- Forensic Science SA and School of Medicine, The University of Adelaide, Level 2 Helen Mayo Building North, Frome Road, Adelaide, South Australia, 5005, Australia.
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26
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Oren N, Vaysberg A, Ginat DT. Updated WHO nomenclature of head and neck lesions and associated imaging findings. Insights Imaging 2019; 10:72. [PMID: 31312967 PMCID: PMC6635538 DOI: 10.1186/s13244-019-0760-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/18/2019] [Indexed: 12/22/2022] Open
Abstract
This article reviews the imaging features of head and neck lesions with updated 2017 World Health Organization (WHO) nomenclature. The major WHO changes include refined terminology of existing entities, descriptions of new tumor types, elimination of defunct categories, and updated biological characterization of various tumor types. In particular, the updates pertaining to the following conditions will be reviewed: tumors of the oral cavity and oropharynx, including HPV-positive or HPV-negative squamous cell carcinoma, small cell carcinoma; tumors of the hypopharynx, larynx, trachea, and parapharyngeal space, including nomenclature revisions for laryngeal neuroendocrine tumors; tumors of the nasal cavity and paranasal sinuses including newly added entities such as NUT carcinoma and biphenotypic sinonasal sarcoma; odontogenic and maxillofacial bone tumors, including the reversal of terminology for certain cystic lesions; tumors of the salivary glands, including updated terminology related to high-grade transformation and polymorphous adenocarcinomas tumors; temporal bone lesions including modifications of the nomenclature and classification criteria; tumor-like lesions of the neck and lymph nodes, with a discussion encompassing developmental cysts, metastases of unknown primary, and heterotopia-associated neoplasia; and mucosal melanoma. Familiarity with the proper WHO terminology for conditions that might be mentioned in differential diagnoses and a general understanding of the behavior of head and neck lesions can help optimize imaging assessment and reporting.
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Affiliation(s)
- Nisa Oren
- Department of Radiology, Section of Neuroradiology, University of Chicago, 5841 S Maryland Avenue, Chicago, IL, 60637, USA
| | - Anatoliy Vaysberg
- Department of Radiology, Section of Neuroradiology, University of Chicago, 5841 S Maryland Avenue, Chicago, IL, 60637, USA
| | - Daniel T Ginat
- Department of Radiology, Section of Neuroradiology, University of Chicago, 5841 S Maryland Avenue, Chicago, IL, 60637, USA.
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27
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Invasive primary papillary carcinoma in a thyroglossal duct cyst: A case report and review of the literature. HUMAN PATHOLOGY: CASE REPORTS 2019. [DOI: 10.1016/j.ehpc.2018.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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28
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Roehlen N, Takacs S, Ebeling O, Seufert J, Laubner K. Ectopic papillary thyroid carcinoma within a thyroglossal duct cyst: A case report. Medicine (Baltimore) 2017; 96:e8921. [PMID: 29310383 PMCID: PMC5728784 DOI: 10.1097/md.0000000000008921] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
RATIONALE Ectopic thyroid carcinoma within a thyroglossal duct cyst (TGDCCa) is an extremely rare entity. Thus, there is no unified appropriate therapeutic strategy, and individual approaches are controversial. PATIENTS CONCERNS We report the case of a 21-year old woman who underwent Sistrunk procedure for a thyroglossal duct cyst (TGDC). DIAGNOSES During histological evaluation of the resected TGDC a papillary thyroid carcinoma was found. INTERVENTIONS Due to a tumor size of 1cm and proximity to the surgical border, Sistrunk procedure was extended by total thyroidectomy, followed by radioiodine ablation. OUTCOMES Except of minimal follicular hyperplasia, the histological examination of the resected thyroid gland was unsuspicious. LESSONS Therapeutic management of TGDCCa is of interdisciplinary debate due to relative infrequence of the disease and consequently lack of unified therapeutic guidelines. We suggest a personalized therapeutic approach adjusted to individual risk stratification. In young patients with small tumor size and with confirmation of TGDCCa representing the primary tumor, Sistrunk procedure alone may reflect adequate treatment. In all other cases, total thyroidectomy and radioiodine ablation should be evaluated. Overall TGDCCa have an excellent prognosis with a 5-year survival rate of more than 90%.
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Affiliation(s)
- Natascha Roehlen
- Division of Endocrinology and Diabetology, Department of Medicine II, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg
| | | | - Olaf Ebeling
- Department of Ear, Nose, Throat and Plastic Surgery, Ortenau Hospital Lahr, Lahr, Germany
| | - Jochen Seufert
- Division of Endocrinology and Diabetology, Department of Medicine II, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg
| | - Katharina Laubner
- Division of Endocrinology and Diabetology, Department of Medicine II, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg
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29
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Zhu YY, Wang CG, Li WY, Gao ZQ, Chen XM. Papillary thyroglossal duct carcinoma: report of nine cases and review of literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:10102-10111. [PMID: 31966901 PMCID: PMC6965942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 08/10/2017] [Indexed: 06/10/2023]
Abstract
BACKGROUND Thyroglossal duct carcinoma (TDCa) is a rare malignancy. Thus, we summarized the clinical characteristics of TDCa to explore the strategy of diagnosis, surgical treatment, and prognosis of patients with papillary TDCa. CASE PRESENTATION A retrospective study was conducted about the medical records of cases with TDCa. General information including the diagnosis, surgical treatment, and prognosis of patients were obtained and analyzed. A total of 480 patients with thyroglossal duct anomalies were treated in our hospital during 1981 to 2011. Nine patients were identified as papillary TDCa and Sistrunk procedure was performed in these patients. Total thyroidectomy and selected neck dissection were performed in 3 TDCa patients with additional multiple thyroid nodules at presentation, of whom one was diagnosed as papillary thyroid carcinoma and another was found to have lymph node metastases. With a median follow-up of 119 months, all patients were alive with no recurrences or metastases. CONCLUSIONS Although the incidence of TDCa is very low, early diagnosis and surgical operation of TDCa should be performed as soon as possible. Besides, the pathological examination is the only way to confirm the diagnosis, and surgery, especially Sistrunk's procedure, is the prior choice of the treatments. In the presence of thyroid lesions or cervical lymphadenopathy, total thyroidectomy and neck dissection should be considered.
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Affiliation(s)
- Ying-Ying Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing, China
| | - Cheng-Gang Wang
- Department of Otolaryngology-Head and Neck Surgery, Qujing Second People’s Hospital of Yunnan ProvinceYunnan, China
| | - Wu-Yi Li
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing, China
| | - Zhi-Qiang Gao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing, China
| | - Xing-Ming Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing, China
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30
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Thompson LDR, Herrera HB, Lau SK. Thyroglossal Duct Cyst Carcinomas in Pediatric Patients: Report of Two Cases with a Comprehensive Literature Review. Head Neck Pathol 2017; 11:442-449. [PMID: 28293858 PMCID: PMC5677077 DOI: 10.1007/s12105-017-0807-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 03/01/2017] [Indexed: 10/20/2022]
Abstract
Thyroglossal duct cyst (TGDC) carcinomas are rarely encountered in the pediatric population. The clinical behavior of these tumors in the pediatric setting is unclear and management is not well defined. Two cases of pediatric thyroglossal duct cyst carcinoma were identified in a review of all thyroglossal duct cysts diagnosed over a ten year period. These two cases were analyzed along with 57 cases of thyroglossal duct cyst carcinoma affecting patients less than 21 years of age compiled from the English literature. Fifty-nine patients (36 females, 23 males) aged 6-20 years (mean 15.0 years) were identified. All presented with an anterior midline neck mass, which was typically mobile and non-tender. The average tumor size was 2.6 cm. Histologically, all tumors were papillary thyroid carcinomas arising in a background of a thyroglossal duct cyst. The tumors exhibited a papillary, follicular, or mixed architecture with classical papillary thyroid carcinoma nuclear features. Soft tissue extension was present in 16 cases. All patients were managed surgically with a Sistrunk procedure, with additional thyroidectomy performed in 29 patients, combined with a lymph node dissection (n = 15), or a Sistrunk and lymph node dissection (n = 5). All patients were stage I at presentation, with 11 showing lymph node metastases. Postoperative radioactive iodine was employed in 20 patients. A papillary carcinoma of the thyroid gland was reported in four of the patients who had concurrent/subsequent thyroidectomies. Recurrences were reported in four patients, with distant metastases in one patient, who died of disease (13 months). Follow up data was available for 45 patients, with an overall mean follow-up of 54.5 months. All patients were alive, with the exception of one who died with disease. TGDC carcinomas in pediatric patients is associated with a good overall prognosis, best managed by Sistrunk procedure alone, with selected lymph node dissection if clinically indicated.
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Affiliation(s)
- Lester D. R. Thompson
- 0000 0004 0445 0789grid.417224.6Southern California Permanente Medical Group, Department of Pathology, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91365 USA
| | - Hannah B. Herrera
- 0000 0004 0445 0789grid.417224.6Southern California Permanente Medical Group, Department of Pathology, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91365 USA
| | - Sean K. Lau
- Department of Pathology, Orange County-Anaheim Medical Center, Anaheim, CA USA
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