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Spinelli C, Ghionzoli M, Ugolini C, Oreglio C, Guglielmo C, Morabito A, Patrizio A, Fallahi P, Ferrari SM, Antonelli A. Does thyroglossal duct arborization play a role in the post-surgical outcome of Sistrunk procedure in children? Eur Arch Otorhinolaryngol 2024; 281:3791-3796. [PMID: 38594507 PMCID: PMC11211129 DOI: 10.1007/s00405-024-08631-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE The purpose of the present study is to analyze thyroglossal duct cyst (TGDC) histopathological features, with focus on "arborization", in a cohort of pediatric patients who underwent surgical removal, and evaluate a possible correlation with clinical recurrences. METHODS A retrospective analysis of all patients who underwent surgical resection for TGDC at the division of Pediatric Surgery of the University of Pisa from 2015 to 2020 was performed; for each patient, the following data were recorded: age, sex, clinical presentation, localization, size of the lesion, diagnostic tools, histopathological features, perioperative complications, recurrence and follow-up. RESULTS With respect to arborization, following histopathological analysis 25/30 patients (83.3%) presented thyroglossal duct branching. After a median follow-up of 3.5 years, only 2 out of 30 patients (6.7%), one male and one female, respectively aged 4 y.o. and 6 y.o., presented recurrence within one year from first surgery. CONCLUSION Surgery for TGDC remains a challenge for pediatric surgeons, while arborization was present in most of our cases which underwent surgery. With respect to the role of arborization, our study did not highlight sufficient conclusive data regarding their role in recurrence: instead, it showed wide resection as satisfactory, being the arborization present in most of the cases at histopathology.
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Affiliation(s)
- Claudio Spinelli
- Division of Pediatric and Adolescent Surgery, Department of Surgery, University of Pisa, Pisa, Italy
| | - Marco Ghionzoli
- Division of Pediatric and Adolescent Surgery, Department of Surgery, University of Pisa, Pisa, Italy
| | - Clara Ugolini
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italia
| | - Chiara Oreglio
- Department of Pediatric Surgery, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Carla Guglielmo
- Division of Pediatric and Adolescent Surgery, Department of Surgery, University of Pisa, Pisa, Italy
| | - Antonino Morabito
- Department of Pediatric Surgery, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Armando Patrizio
- Department of Emergency Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Poupak Fallahi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | - Alessandro Antonelli
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italia.
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2
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Pop R, Oren S, Negoescu A, Cătoi C, Tăbăran AF. Case report: The first description of a thyroglossal duct cyst in a hen ( Gallus gallus domesticus). Front Vet Sci 2024; 11:1388152. [PMID: 38711537 PMCID: PMC11071344 DOI: 10.3389/fvets.2024.1388152] [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] [Received: 02/19/2024] [Accepted: 03/27/2024] [Indexed: 05/08/2024] Open
Abstract
Thyroglossal duct cyst represents a congenital anomaly of the cervical region, rarely documented in animals. Although previously reported in dogs, cats, horses, goats, pigs, and calves, never in birds. This report describes a rare case of thyroglossal duct cyst in a hen. A necropsy of a Transylvanian Naked Neck hen carried following diphtheroid mucocutaneous lesions. The necropsy revealed a large, cyst-like structure measuring 0.5 cm at the level of the caudal edge of the left thyroid gland. Histologically, the cystic mass, bordered by 1-2 lines of well-differentiated ciliated cuboidal cells, presented nuclear immunoreactivity for Thyroid transcription factor 1. To the best of the authors' knowledge, there are no previous records of thyroglossal duct cysts in avians. Moreover, this is the first case describing a thyroglossal duct cyst in a hen.
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Affiliation(s)
- Romelia Pop
- Department of Anatomic Pathology, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Stephanie Oren
- Department of Anatomic Pathology, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
- Departament of Pathology, Kimron Veterinary Institute, Bet Dagan, Israel
| | - Andrada Negoescu
- Department of Anatomic Pathology, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Cornel Cătoi
- Department of Anatomic Pathology, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Alexandru-Flaviu Tăbăran
- Department of Anatomic Pathology, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
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3
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Salih AM, Qaradakhy AJ, Saeed YA, Muhialdeen AS, Dhahir HM, Abdullah AM, Ahmed SF, Hassan SH, Rahim HM, Ali MBA, Abdalla BA, Hussein BO, Kakamad FH. Carcinoma arising from thyroglossal duct remnants. Biomed Rep 2024; 20:60. [PMID: 38414626 PMCID: PMC10895460 DOI: 10.3892/br.2024.1748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/11/2024] [Indexed: 02/29/2024] Open
Abstract
Thyroglossal duct cysts (TGDCs) are unusual remnants of the thyroid gland that are rarely observed in association with carcinoma. The present study aimed to showcase the clinical characteristics, diagnosis and management of patients with TGDC carcinoma. It was a single-center study conducted from February 2016 to February 2020. The study involved the retrospective analysis of a series of cases with TGDC carcinoma. A total of 10 patients were included in the study, of whom eight (80%) were females. Their age ranged from 25 to 48 years with a mean age of 39.1 years. A total of five cases (50%) underwent only Sistrunk's procedure, four patients (40%) underwent total thyroidectomy along with Sistrunk's procedure and one patient (10%) was treated by Sistrunk operation and lobectomy. In all of the cases (100%), histopathological examination confirmed papillary thyroid carcinoma in TGDCs. In addition, in the thyroid tissue, 2 cases (20%) also had papillary thyroid carcinoma and 3 cases (30%) had papillary thyroid microcarcinoma. Radioiodine was administered in one patient (10%) with suppressive thyroxine. A three-year follow-up with ultrasound revealed no suspicious lesions in any of the cases. Although rare, carcinoma may develop in the thyroglossal cysts. In this situation, both the thyroid gland and different lymph node compartments should be evaluated for malignancy. Surgical intervention is the cornerstone of management.
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Affiliation(s)
- Abdulwahid M Salih
- Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
| | - Aras J Qaradakhy
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Radiology, Shorsh Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
| | | | - Aso S Muhialdeen
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization, Sulaimani, Kurdistan 46001, Iraq
| | | | - Ari M Abdullah
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Pathology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
| | - Shaho F Ahmed
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
| | - Shko H Hassan
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
| | - Hawbash M Rahim
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization, Sulaimani, Kurdistan 46001, Iraq
- Department of Medical Laboratory Science, College of Health Sciences, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
| | - Muhammed Bag A Ali
- Smart Health Tower-Raparin Branch, Raniyah, Sulaimani, Kurdistan 46001, Iraq
| | - Berun A Abdalla
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization, Sulaimani, Kurdistan 46001, Iraq
| | | | - Fahmi H Kakamad
- Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization, Sulaimani, Kurdistan 46001, Iraq
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Chen C, Liu F, Fang J, Sima L, Ni L, Xiang S, Xia S. Clinical Characteristics and Prognosis of Infants and Children <3 Years of Age With Thyroglossal Duct Cyst Complicated With a Parapharyngeal Mass: A Case Series Study. Clin Pediatr (Phila) 2024; 63:318-324. [PMID: 37139812 DOI: 10.1177/00099228231171784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
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.
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Affiliation(s)
- Caidi Chen
- Department of Otolaryngology Head & Neck Surgery, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fanli Liu
- Department of Otolaryngology Head & Neck Surgery, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jianjing Fang
- Department of Ultrasonography, Wuma Street Community Health Service Center of Lucheng District, Wenzhou, China
| | - Linyuan Sima
- Department of Otolaryngology Head & Neck Surgery, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Liyan Ni
- Department of Otolaryngology Head & Neck Surgery, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Songjie Xiang
- Department of Otolaryngology Head & Neck Surgery, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Siwen Xia
- Department of Otolaryngology Head & Neck Surgery, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
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Bishop GL, Jasim S, Strnad BS, Itani M. Papillary Thyroid Cancer in Thyroglossal Duct Cysts: A Pictorial Review and Case Series. Ultrasound Q 2023; 39:194-198. [PMID: 37702545 DOI: 10.1097/ruq.0000000000000650] [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: 09/14/2023]
Abstract
ABSTRACT Thyroglossal duct cyst is the most common congenital neck mass, but the incidence of malignancy within a thyroglossal duct cyst is rare, estimated at 1%. Most cancers arising within thyroglossal duct cysts are incidentally detected after surgical excision. We present the preoperative radiologic findings of 8 patients with papillary thyroid cancer arising within a thyroglossal duct cyst, as evaluated on ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography scan.
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Affiliation(s)
| | - Sina Jasim
- Division of Endocrinology, Metabolism and Lipid Research, School of Medicine, Washington University in St Louis, St Louis, MO
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6
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Summersgill KF. Pediatric Oral Pathology: Odontogenic Cysts. Pediatr Dev Pathol 2023; 26:609-620. [PMID: 37212213 DOI: 10.1177/10935266231176245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Cysts encountered in the head and neck typically arise from epithelium that would normally be programmed to form teeth or tooth-supporting structures (odontogenic epithelium). These cysts come with a confusing array of similar-sounding names and histopathologic features that are sometimes shared between conditions. Here we describe and contrast the relatively-common lesions: hyperplastic dental follicle, dentigerous cyst, radicular cyst, buccal bifurcation cyst, odontogenic keratocyst, glandular odontogenic cyst, and the less-common gingival cyst of the new-born and thyroglossal duct cyst. The goal of this review is to help clarify and simplify these lesions for the general pathologist, pediatric pathologist, and surgeon.
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7
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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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8
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Bhandarwar AH, Balamurugan G, Jadhav S, Tandur A, Jagdale S. Endoscopic sistrunk using bilateral axillo-breast approach - A minimal access technique for thyroglossal duct cysts. J Minim Access Surg 2023; 19:329-331. [PMID: 37056095 PMCID: PMC10246635 DOI: 10.4103/jmas.jmas_64_22] [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: 02/06/2022] [Revised: 06/12/2022] [Accepted: 07/10/2022] [Indexed: 04/15/2023] Open
Abstract
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.
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Affiliation(s)
- Ajay H. Bhandarwar
- Department of General Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - G. Balamurugan
- Department of General Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Shekhar Jadhav
- Department of General Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Amarjeet Tandur
- Department of General Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Saurabh Jagdale
- Department of General Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
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9
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Muhialdeen AS, Salih AM, Ahmed MM, Saeed YA, Qaradakhy AJ, Baba HO, Abdullah AM, Kakamad FH, Mohammed SH, Hiwa DS, Mohammed MS, Najmadden ZB. Thyroglossal duct diseases: presentation and outcomes. J Int Med Res 2023; 51:3000605231154392. [PMID: 36799092 PMCID: PMC9940199 DOI: 10.1177/03000605231154392] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE The incidence of thyroglossal duct diseases in the general population is about 7%. We aimed to demonstrate the clinical presentations and management of thyroglossal duct diseases. METHODS We conducted a retrospective review of all patients who underwent surgery for histopathologically confirmed thyroglossal duct cyst, sinus, or fistula at a single center. RESULTS A total of 151 cases were included in this study. There were more female patients (87, 58%) than male patients (64, 42%). The patients' ages ranged from 1 to 63 years old. The most prevalent complaint was painless upper midline neck swelling (93.3%). Most cases were diagnosed as thyroglossal duct cysts (137, 90.7%). Six cases (4%) were associated with carcinoma. All the cases were managed using the modified Sistrunk procedure. There were no procedure-related complications, and five cases of recurrence. CONCLUSIONS Although thyroglossal duct cyst is the most common neck anomaly in children, it may also present with various characteristics later in life. This condition can be managed successfully without complications and with a low recurrence rate.
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Affiliation(s)
- Aso S. Muhialdeen
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Abdulwahid M. Salih
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Mohsin M. Ahmed
- Department of Surgery, Teaching Hospital, Ministry of Health, Sulaimani, Kurdistan, Iraq
| | - Yadgar A. Saeed
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Aras J. Qaradakhy
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,Department of Radiology, Shorsh Teaching Hospital, Sulaimani, Kurdistan, Iraq
| | - Hiwa O. Baba
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Ari M. Abdullah
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Fahmi H. Kakamad
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq,College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,Fahmi Hussein Kakamad, Doctor City, Building 11, Apartment 50, Sulaimani, Kurdistan 46001, Iraq.
| | - Shvan H. Mohammed
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Dilan Sarmad Hiwa
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
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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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11
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Muacevic A, Adler JR, Ajagbe O, Ishola A. Management Outcome of Adult Thyroglossal Duct Cyst in a General Surgery Tertiary Practice in Sub-Saharan Africa, Nigeria. Cureus 2022; 14:e31833. [PMID: 36579290 PMCID: PMC9788839 DOI: 10.7759/cureus.31833] [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: 09/30/2022] [Indexed: 11/24/2022] Open
Abstract
Thyroglossal duct cyst (TDC) is a rare condition in adults. This is a report of its presentation and standard treatment with good outcome in adults in a Sub-Saharan tertiary hospital. It is a retrospective review of five adult patients who were managed over a five-year period culled from archived records and casenotes. The three males and two females have a median age of 35 years and a range of 15-74 years. Each of them presented with anterior neck masses while one, in addition, had a painful swelling with a discharging sinus. The median duration of the symptoms was 4.5 years. Four of the cysts were in the infrahyoid location and all the patients had a Sistrunk operation. The median duration of follow-up was six months, without complications. Surgeons need to have a high level of suspicion for this condition in adults.
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12
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Mustafa AA, Favre NM, Kabalan MJ, Carr MM. Pediatric thyroglossal duct cyst excision: A NSQIP-P analysis of 30-day complications. Int J Pediatr Otorhinolaryngol 2021; 150:110937. [PMID: 34628171 DOI: 10.1016/j.ijporl.2021.110937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/17/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Identify and compare clinical risk factors, perioperative sequelae, and surgical complications of infants age 2 or younger to children above age 2 undergoing thyroglossal duct cyst (TGDC) excision. METHODS Retrospective analysis of the American College of Surgeons National Surgical Quality Improvement-Pediatric Database (2014-2018). Study population includes pediatric patients (≤18 years) who underwent excision of TGDC. Infants aged 2 years or younger were compared to children older than 2 years. RESULTS A total of 3052 cases were identified. There were 375 infants with an age of 2 years or younger and 2977 children who were older than 2 years. Mean age at time of surgery was 6.3 years, with a female-to-male ratio of 1:1.1. Following hospital discharge, there were 70 related readmissions and 3 related reoperations. There was no statistically significant gender (p = .270) or ethnic (p = .122) differences between groups. Additionally, a history of prematurity (p = .759) and postoperative admission status (ie, inpatient versus outpatient, p = .697) were not statistically significantly different between groups. Lastly, general complication rates between age groups including Clostridium difficile colitis, occurrences of bleeding and blood transfusion, surgical site infections, related readmission, and reoperation were not statistically significantly different. CONCLUSION TGDC excision was not shown to be associated with increased risk when performed in infants age 2 or younger compared to children older than age 2.
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Affiliation(s)
- Ayman A Mustafa
- Department of Otolaryngology, Jacobs School of Medicine & Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA
| | - Nicole M Favre
- Department of Otolaryngology, Jacobs School of Medicine & Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA
| | - Matthew J Kabalan
- Department of Otolaryngology, Jacobs School of Medicine & Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA
| | - Michele M Carr
- Department of Otolaryngology, Jacobs School of Medicine & Biomedical Sciences at the University at Buffalo, Buffalo, NY, USA.
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13
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Cavernous hemangioma within a thyroglossal duct cyst. OTOLARYNGOLOGY CASE REPORTS 2021. [DOI: 10.1016/j.xocr.2021.100378] [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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14
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Cordes M, Coerper S, Kuwert T, Schmidkonz C. Ultrasound Imaging of Cervical Anatomic Variants. Curr Med Imaging 2021; 17:966-972. [PMID: 33504311 PMCID: PMC8653420 DOI: 10.2174/1573405617666210127162328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 11/30/2022]
Abstract
Embryologic developmental variants of the thyroid and parathyroid glands may cause cervical anomalies that are detectable in ultrasound examinations of the neck. For some of these developmental variants, molecular genetic factors have been identified. Ultrasound, as the first-line imaging procedure, has proven useful in detecting clinically relevant anatomic variants. The aim of this article was to systematically summarize the ultrasound characteristics of developmental variants of the thyroid and parathyroid glands as well as ectopic thymus and neck cysts. Quantitative measures were developed based on our findings and the respective literature. Developmental anomalies frequently manifest as cysts that can be detected by cervical ultrasound examinations. Median neck cysts are the most common congenital cervical cystic lesions, with a reported prevalence of 7% in the general population. Besides cystic malformations, developmental anomalies may appear as ectopic or dystopic tissue. Ectopic thyroid tissue is observed in the midline of the neck in most patients and has a prevalence of 1/100,000 to 1/300,000. Lingual thyroid accounts for 90% of cases of ectopic thyroid tissue. Zuckerkandl tubercles (ZTs) have been detected in 55% of all thyroid lobes. Prominent ZTs are frequently observed in thyroid lobes affected by autoimmune thyroiditis compared with normal lobes or nodular lobes (P = 0.006). The correct interpretation of the ultrasound characteristics of these variants is essential to establish the clinical diagnosis. In the preoperative assessment, the identification of these cervical anomalies via ultrasound examination is indispensable.
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Affiliation(s)
- Michael Cordes
- Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Germany
| | - Stephan Coerper
- Klinik für Chirurgie, Martha-Maria-Krankenhaus, Nürnberg, Germany
| | - Torsten Kuwert
- Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Germany
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15
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Kim H, Woo SH. Endoscopically-Assisted Scar-Free Midline Neck Mass Excision. Clin Exp Otorhinolaryngol 2021; 14:251-258. [PMID: 34407369 PMCID: PMC8373841 DOI: 10.21053/ceo.2020.02446] [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] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 06/25/2021] [Indexed: 11/22/2022] Open
Abstract
Traditional open surgery is indicated for the treatment of selected tumor subsites in the head and neck. However, it can cause major cosmetic problems and functional pathologies. The endoscopically-assisted transoral approach is increasingly preferred in some surgical fields due to its superior cosmetic and functional outcomes. Nonetheless, endoscopically-assisted transoral approach is not yet standard in the head and neck due to their anatomical complexity. The transoral surgical approach has been used for head and neck masses since the 1960s, and its application continues to evolve with changing disease conditions and recent innovations in surgical instruments. The potential for wide application of transoral surgery continues to be investigated, with a focus on minimizing occurrence of the complications. This review presents details of the surgical procedure and postoperative clinical outcomes, as well as endoscopically-assisted scar-free techniques for the resection of midline neck masses.
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Affiliation(s)
- Hyoyeon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
| | - Seung Hoon Woo
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
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16
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Karatay E, Javadov M. The effectiveness of ethanol ablation in the treatment of thyroglossal duct cysts in adult cases and evaluation with cosmetic scoring. Jpn J Radiol 2021; 39:994-999. [PMID: 33993431 DOI: 10.1007/s11604-021-01135-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 05/11/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to evaluate thyroglossal duct cyst (TGDC) volumes before and after treatment with ultrasound (US) in patients who underwent ethanol ablation (EA). Besides, the usability of cosmetic scoring in TGDC cases was investigated by comparing cosmetic scores pre-treatment and after EA. MATERIALS AND METHODS 28 TGDC cases who had EA in one session and had complete US data and cosmetic scores were included in the study. US data including TGDC diameters and volumes obtained at the pre-treatment, 3rd, 6th, and 12th month after EA were noted, respectively. Cosmetic scoring was performed pre-treatment and after EA using the WHO grading system simultaneously with US. RESULTS At the 12th month after EA, there was 85.2% reduction in mean diameter and 95.1% reduction in mean volume in TGDC cases (p < 0.001). The mean cosmetic score pre-treatment was 2.7 ± 0.8 and the mean cosmetic score at the 12th month was 1 (p < 0.001). When the changes in TGDC volumes and cosmetic scoring after EA were compared according to gender and age, there was no statistically significant difference (p > 0.05). CONCLUSION The current study demonstrated that EA can be used safely to reduce TGDC sizes and is an alternative treatment option to surgery.
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Affiliation(s)
- Emrah Karatay
- Department of Radiology, Istanbul Kartal Dr. Lutfi Kirdar City Hospital, D-100 Güney Yanyol No:47 Cevizli Mevkii Kartal, 34865, Istanbul, Turkey.
| | - Mirkhalig Javadov
- Department of General Surgery, Yeditepe University Faculty Of Medicine, Istanbul, Turkey
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17
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Alahmadi AA, Bawazir OA, Rajab MK, Althobaiti IA, Bawazir AO, Abi Sheffah FR, Al-Tammas AH, Marglani OA, Heaphy JC, Alherabi AZ. Thyroglossal duct surgery. What is the acceptable recurrence rate? Saudi Med J 2020; 41:878-882. [PMID: 32789430 PMCID: PMC7502963 DOI: 10.15537/smj.2020.8.25169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/12/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To present experiences of different specialties in the treatment of thyroglossal duct cysts (TGDCs) and subsequent complications in multiple centers. Methods: A retrospective cross-sectional study of all cases of TGDC for a period of 11 years from 2008-2019 by different departments from 3 different centers in Jeddah, Kingdom of Saudi Arabia (King Faisal Specialist Hospital and Research Centre, Bakhsh Hospital and International Medical Center). Results: Forty-nine patients were included. The type of surgery performed plays a significant role in recurrence (p less than 0.001). The Sistrunk procedure had a lower recurrence rate (0%) than simple excision (70%) and has showed a significantly long recurrence-free interval (p less than 0.001). Higher recurrence rates are associated with higher postoperative complications (p=0.002). Patients who underwent pre-operative fine needle aspiration did not have any recurrence during the follow-up period. Conclusion: The Sistrunk procedure is the gold standard technique with the highest recurrence-free interval rate. Fine needle aspiration could be recommended as a less invasive procedure to exclude malignancy.
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Affiliation(s)
- Asma A Alahmadi
- Department of Otolaryngology-Head & Neck Surgery, King Faisal Specialist Hospital & Research Centre, Jeddah, Kingdom of Saudi Arabia. E-mail.
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18
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Ogunkeyede SA, Ogundoyin OO. Management outcome of thyroglossal cyst in a tertiary health center in Southwest Nigeria. Pan Afr Med J 2020; 34:154. [PMID: 32110270 PMCID: PMC7024141 DOI: 10.11604/pamj.2019.34.154.18765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/23/2019] [Indexed: 11/11/2022] Open
Abstract
Thyroglossal duct cyst is a non-odontogenic congenital developmental cyst. It is predominantly a midline anterior neck swelling in children and total excision of the tracts prevents recurrence. Retrospective hospital record analysis of patients managed with histopathology results of thyroglossal cyst between 2003 and 2018. Comparing outcomes and technique of thyroglossal cyst excision in a resource challenged environment. A total of 37 patients comprising 22(59.5%) males and 15(40.5%) females (M:F 1.4:1) with age range of 13 days to 55 years (median 6 years) were managed. The majority were children less than 10 years of age. They all presented with a fluctuant midline progressive anterior neck swelling, in addition to anterior neck ulcer 1(2.7%), discharging sinuses 3(8.1%) and thyroglossal cyst duct infections, which were managed successfully with antibiotics. Central compartment neck dissection with excision of mid-portion of the hyoid bone was performed in all the patients. Rupture of thyroglossal duct cysts was observed in 7(18.9%) at surgery, but there was no recurrence. Surgical drain was not used and most patients were discharged within 48 hours postoperatively. Thyroglossal duct cyst was confirmed at histology without any evidence of mitotic changes. There was no recurrence for the Sistrunk's procedure in all specialties. The modification of the Sistrunk's procedure with mid-anterior neck dissection is effective in excising a thyroglossal duct cyst, hence preventing recurrence. Non-usage of wound drains and short hospital stay are cost effective.
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Affiliation(s)
- Segun Ayodeji Ogunkeyede
- Department of Otorhinolaryngology, College of Medicine, University of Ibadan, Ibadan, Nigeria.,University College Hospital, Ibadan, Nigeria
| | - Olakayode Olaolu Ogundoyin
- University College Hospital, Ibadan, Nigeria.,Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
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19
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Miller E, Finn LS, Boos MD. Subcutaneous Nodule of the Midline Anterior Neck in an Infant. JAMA Otolaryngol Head Neck Surg 2020; 146:196-197. [PMID: 31774475 DOI: 10.1001/jamaoto.2019.3551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Laura S Finn
- Department of Laboratories, Seattle Children's Hospital, Seattle, Washington.,Department of Pathology, University of Washington School of Medicine, Seattle
| | - Markus D Boos
- Division of Dermatology, Department of Pediatrics, University of Washington School of Medicine, Seattle.,Seattle Children's Hospital, Seattle, Washington
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20
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Lee YJ, Kim DW, Shin GW, Park JY, Choo HJ, Park HK, Ha TK, Kim DH, Jung SJ, Park JS, Moon SH, Ahn KJ, Baek HJ. Comparison of Prevalence and Ultrasonography Features of Thyroglossal Duct Cyst in Adults According to Radioactive Iodine Ablation. Med Sci Monit 2019; 25:9538-9546. [PMID: 31837133 PMCID: PMC6929556 DOI: 10.12659/msm.919324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the prevalence of thyroglossal duct cysts (TGDCs) on ultrasonography (US) and US features of TGDCs in adults, and to assess whether the prevalence or size of TGDCs increases after radioactive iodine ablation (RIA). MATERIAL AND METHODS Between July and December 2018, 2820 patients underwent thyroid or neck US examination, performed by 2 radiologists, at our center. On the basis of real-time US, the presence or absence of TGDCs was prospectively investigated by 2 radiologists. Among the 2820 patients, 54 patients who were <19 years of age or had a radiation therapy history to the neck were excluded. Eventually, 2766 patients were included. RESULTS Of the 2766 patients, 160 (5.8%) showed a TGDC on US. The mean size of TGDCs in RIA history (+) (n=36) and RIA history (-) (n=124) groups was 0.92±0.41 cm and 0.86±0.45 cm, respectively. There was no significant difference in size of TGDCs between RIA history (+) and RIA history (-) groups (p=0.684). Between the TGDC (+) and TGDC (-) groups, there was no significant difference in patient age, gender, reason for thyroid/neck US, type of thyroid surgery, and session number and application/no application of RIA (p>0.05). The prevalence rate of TGDCs in radiologist A and B was 4.9% (70/1427) and 6.7% (90/1339), respectively. TGDCs were more common in the suprahyoid neck, and the common shapes of TGDCs were flat-to-ovoid and round. CONCLUSIONS RIA may not be associated with the prevalence or enlargement of TGDCs.
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Affiliation(s)
- Yoo Jin Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Dong Wook Kim
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Gi Won Shin
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Jin Young Park
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Hye Jung Choo
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Ha Kyoung Park
- Department of General Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Tae Kwun Ha
- Department of General Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Do Hun Kim
- Department of Otorhinolaryngology - Head and Neck Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Soo Jin Jung
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Ji Sun Park
- Department of Nuclear Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Sung Ho Moon
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Ki Jung Ahn
- Department of Radiation Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Hye Jin Baek
- Department of Radiology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, South Korea
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21
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Sigvaldason H, Graham S, Buksak R, Pathak KA. A Malignant Cystic Midline Neck Mass. OTO Open 2019; 3:2473974X19849046. [PMID: 31535072 PMCID: PMC6737876 DOI: 10.1177/2473974x19849046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/04/2019] [Accepted: 04/17/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
- Heather Sigvaldason
- Surgical Oncology, Department of Surgery, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Sheena Graham
- Surgical Oncology, Department of Surgery, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Raena Buksak
- College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Shared Health Manitoba, Winnipeg, Manitoba, Canada
| | - K Alok Pathak
- Surgical Oncology, Department of Surgery, CancerCare Manitoba, Winnipeg, Manitoba, Canada.,College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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22
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Thyroglossal Duct Cyst Carcinoma in a Young Female: Case Report and Review of Literature. Case Rep Otolaryngol 2019; 2019:4069375. [PMID: 31467756 PMCID: PMC6701270 DOI: 10.1155/2019/4069375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/22/2019] [Indexed: 12/31/2022] Open
Abstract
Thyroglossal duct remnants form during embryologic development and can develop into a thyroglossal duct cyst (TGDC). In rare cases, carcinoma is present within these cysts, most commonly papillary thyroid carcinoma. Diagnosis is difficult, but imaging and fine-needle aspiration (FNA) biopsies can help with the diagnosis. Given the rarity of TGDC carcinoma, treatment is not well agreed upon and can include the Sistrunk procedure, thyroidectomy, nodal dissection, and postoperative radioactive iodine treatment. Here, we describe the presentation, workup, and treatment of a 20-year-old female with papillary thyroid carcinoma present within both a thyroglossal duct cyst and the thyroid gland.
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23
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Diom ES, Fagan JJ, Bolding E. Intralingual Mucous Extravasation Cyst: An Uncommon Lingual Cyst. EAR, NOSE & THROAT JOURNAL 2019; 98:E21-E23. [PMID: 30943808 DOI: 10.1177/0145561319836303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE We report a rare case of an intralingual ranula. The differential diagnosis, etiology, diagnostic features, and management are discussed. CASE REPORT An 18-year-old man presented with a mass that extended along the ventral surface of the tongue and up to the tip. The computed tomography scan clearly defined the extent of a cystic lesion. The pathologic diagnosis of an intralingual ranula was made. CONCLUSION Lingual cysts have a varied etiology. Diagnosis hinges on histological examination of the cyst wall. Conservative resection and histological examination is the standard of care.
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Affiliation(s)
- Evelyne S Diom
- 1 Division of Otolaryngology, Groote Schuur Hospital, Cape Town, South Africa
| | - Johannes J Fagan
- 2 University of Cape Town Medical School, Cape Town, South Africa
| | - Ellen Bolding
- 3 Histopathologist, Pathcare, Cape Town, South Africa
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24
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Keelawat S, Bychkov A. Compact buds with biphasic differentiation and calcitonin-expressing neuroendocrine cells—previously unrecognized structures of thyroglossal duct unveiled by immunohistochemistry. Virchows Arch 2019; 474:609-617. [DOI: 10.1007/s00428-019-02536-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 01/28/2019] [Indexed: 12/19/2022]
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25
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Submental Ectopic Thyroid Cyst: An Atypical Presentation. Indian J Otolaryngol Head Neck Surg 2018; 71:712-715. [PMID: 31742048 DOI: 10.1007/s12070-018-1515-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/20/2018] [Indexed: 10/28/2022] Open
Abstract
It is very unusual of an ectopic thyroid to be presented as a submental swelling, clinically mimicking a submental cyst. Suspicious of the disease with complete clinical, biochemical and radiological correlation is the mainstay of diagnosis as the first FNAC is not confirmatory of the ectopic thyroid especially in cases of dysgenesis of thyroid tissue in an unusual location. Here we have presented a rare case of an ectopic thyroid gland presented with a submental swelling successfully managed with the conservative treatment.
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26
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Another Strategy for the Treatment of Thyroglossal Duct Cyst: Totally Endoscopic Surgery by Breast Approach. Surg Laparosc Endosc Percutan Tech 2018. [PMID: 29521676 DOI: 10.1097/sle.0000000000000514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Open surgery is the most common treatment of thyroglossal duct cyst (TGDC), but it leaves obvious neck scarring. This study aimed to explore the feasibility and strategy of total endoscopic procedure by breast approach to avoid such scarring on the neck. MATERIALS AND METHODS This study reviewed 13 patients who underwent endoscopic resection of TGDC and 15 patients who underwent open resection of TGDC. We compared and analyzed factors including operative time, estimated blood loss, postoperative hospitalization, complications, and cosmetic effect. RESULTS The surgery by the endoscopic approach was successfully completed in 13 cases and no one was converted to an open procedure. Another 15 cases were successfully performed by an open procedure. There were no significant differences between the 2 procedures in the mean cyst size, drainage time, intraoperative blood loss, and postoperative hospital stay. The cosmetic effect was better and the operative time was longer in the endoscopic approach. Two cases had swallowing discomfort after surgery in the endoscopic approach, whereas one case developed this complication in the open approach. On patient treated with each approach developed infection. One patient developed skin bruise and one patient developed subcutaneous hydros in the endoscopic approach, whereas no complications developed in the open approach. There were no incidences of uncontrolled bleeding, tracheal injury, dysphagia, salivary fistula, or asphyxia/dyspnea in both approaches, nor were there any deaths or recurrences of TGDC during the follow-up period. CONCLUSION With strict indications, the total endoscopic breast procedure is feasible and effective for selected patients. This procedure can be another choice for patients who wish to avoid neck scarring when undergoing treatment for TGDC.
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27
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Garcia E, Osterbauer B, Parham D, Koempel J. The incidence of microscopic thyroglossal duct tissue superior to the hyoid bone. Laryngoscope 2018; 129:1215-1217. [PMID: 30194760 DOI: 10.1002/lary.27291] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Erick Garcia
- University of Southern California Keck School of MedicineLos Angeles California U.S.A
| | - Beth Osterbauer
- Division of Otolaryngology–Head and Neck SurgeryLos Angeles California U.S.A
| | - David Parham
- Department of Pathology and Laboratory MedicineChildren's Hospital Los AngelesLos Angeles California U.S.A
| | - Jeffrey Koempel
- Division of Otolaryngology–Head and Neck SurgeryLos Angeles California U.S.A
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28
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Farquhar D, Rawal R, Masood M, McClain W, Kilpatrick L, Rose A, Zdanski C. Outpatient management and surgeon specialty for thyroglossal duct cyst excision: A retrospective analysis of 377 patients and 30-day outcomes in the American College of Surgeons NSQIP-P Database. Clin Otolaryngol 2018; 43:1402-1406. [DOI: 10.1111/coa.13170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 11/28/2022]
Affiliation(s)
- D.R. Farquhar
- Department of Otolaryngology/Head and Neck Surgery; University of North Carolina at Chapel Hill School of Medicine; Chapel Hill NC USA
| | - R.B. Rawal
- Department of Otolaryngology/Head and Neck Surgery; University of North Carolina at Chapel Hill School of Medicine; Chapel Hill NC USA
| | - M.M. Masood
- Department of Otolaryngology/Head and Neck Surgery; University of North Carolina at Chapel Hill School of Medicine; Chapel Hill NC USA
| | - W.G. McClain
- Department of Otolaryngology/Head and Neck Surgery; University of North Carolina at Chapel Hill School of Medicine; Chapel Hill NC USA
| | - L.A. Kilpatrick
- Department of Otolaryngology/Head and Neck Surgery; University of North Carolina at Chapel Hill School of Medicine; Chapel Hill NC USA
| | - A.S. Rose
- Department of Otolaryngology/Head and Neck Surgery; University of North Carolina at Chapel Hill School of Medicine; Chapel Hill NC USA
| | - C.J. Zdanski
- Department of Otolaryngology/Head and Neck Surgery; University of North Carolina at Chapel Hill School of Medicine; Chapel Hill NC USA
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Abstract
BACKGROUND No-scar transoral thyroglossal duct cyst (TGDC) excision is a newly developed treatment for TGDC, but limited information is available regarding the clinical outcomes in children. The aim of this study was to evaluate the safety, efficacy, and effects of transoral TGDC excision in children. METHODS Forty-four children <10 years of age received operative treatment for TGDC from January 2013 to December 2014, and follow-up was performed over 24 months. Clinicopathologic, surgical, and follow-up data were collected and analyzed. The primary outcome variable was feasibility of the procedure, and the secondary outcome was patient's cosmetic satisfaction after each operation. RESULTS Twenty-one patients underwent transoral TGDC excision, and 21 patients underwent conventional excision. No significant differences were observed between the two groups in terms of the overall patient and operation factors. However, the rate of identifying the thyroglossal duct during transoral excision was superior to that during conventional excision (p < 0.05), and cosmetic satisfaction was much better in the transoral TGDC excision group (p < 0.001). CONCLUSION No-scar transoral TGDC excision in children is a potentially safe and effective methodology that can achieve easy removal of the thyroglossal duct and excellent cosmetic outcomes.
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Affiliation(s)
- Jin Pyeong Kim
- Department of Otolaryngology—Head and Neck Surgery, Gyeongsang National University, Jinju, Korea
| | - Jung Je Park
- Department of Otolaryngology—Head and Neck Surgery, Gyeongsang National University, Jinju, Korea
| | - Seung Hoon Woo
- Department of Otolaryngology—Head and Neck Surgery, Gyeongsang National University, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
- Beckman Laser Institute, University of California, Irvine, California
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30
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Thyroglossal duct cyst coexisting with a fistulous tract: A rare case report and literature review. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2017.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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31
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Thyroglossal duct cyst surgery: A ten-year single institution experience. Int J Pediatr Otorhinolaryngol 2017; 101:132-136. [PMID: 28964283 DOI: 10.1016/j.ijporl.2017.07.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 06/20/2017] [Accepted: 07/23/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE 1. Review our institution's experience with thyroglossal duct cyst (TGDC) excision. 2. Determine if TGDC recurrence rate is influenced by surgical technique, preoperative infection, or surgeon specialty. METHODS We conducted a retrospective analysis of patients at a tertiary care children's hospital who underwent excision of neck mass with proven TGDC histopathology from 2005 to 2015. Patient demographics and presentation, preoperative workup, surgeon specialty, procedural details, lesion characteristics, and complication rates including recurrence were evaluated. RESULTS 108 patients (51% male, 49% female), aged 6 months to 20 years (mean 6 years) met inclusion criteria. 121 procedures were performed: 96 (79.3%) for primary disease and 25 (20.7%) for recurrence. 32 patients (27.8%) were infected preoperatively, resulting in a significant increase in complications and recurrence (46.9% and 28.1%, respectively). Lack of preoperative imaging was correlated with increased recurrence (p = 0.0002). Recurrence rate after treatment for primary (11.3%) versus secondary disease (24%) was not significant (p = 0.23). Total recurrence rate differed between ENT (9.1%) and Pediatric Surgery (PS) (27.3%) (p = 0.0172). Difference was not significant for recurrence in primary disease (10% ENT, 14.8% PS, p = 0.49), but was for secondary disease (5.6% ENT, 71.4% PS, p = 0.002). Modifications of Sistrunk's procedure did not result in increased rates of recurrence (p = 0.1273). CONCLUSION Preoperative TGDC infection and lack of imaging led to a significant increase in postoperative complications, including recurrence. Surgical specialty significantly affected recurrence rates following excision overall and in secondary disease. Recurrence was not affected by surgical technique, age, sex, cyst size, or mucin rich histology.
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Consalvo V, Barbieri G, Rossetti ARR, Romano M, Contieri R, Tramontano S, Rescigno C, Infranzi M, Lombardi D. Follicular adenoma in ectopic thyroid. A case-report. Int J Surg Case Rep 2017; 40:94-96. [PMID: 28946030 PMCID: PMC5614748 DOI: 10.1016/j.ijscr.2017.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/11/2017] [Accepted: 09/12/2017] [Indexed: 11/25/2022] Open
Abstract
Ectopic thyroid is thyroidal tissue located far from its anatomic place. A patient under our observation displayed left submandibular swelling. The FNAC test report described a follicular adenoma. Based on the FNAC diagnosis, we surgically removed the mass. The post-operative follow-up was uneventful.
Introduction The term ectopic thyroid refers to the presence of thyroid tissue located far from its usual anatomic placement and with no vascular connection to the main gland. The presence of swelling in atypical locations is diagnostically differentiated from other pathologies like pleomorphic adenoma or carcinoma, inflammatory lesions like sialadenitis, neurogenic tumors, paraganglioma, fibrolipoma and lymphadenopaties of diverse etiologies. Presentation of case Here we present the case of a submandibular ectopic thyroid in a 67 year old woman. She came to our attention for a left submandibular swelling. The anamnesis did not show related pathologies, as well as blood tests. Diagnostic image studies and a FNAC were performed. The mass was surgically removed and histopatology showed a follicular adenoma in the contest of the capsulated lesion. Discussion It is important to not underestimate these types of lesions and procede with hematochemical, instrumental tests and above all surgery that can eliminate any diagnostic uncertainty and on the whole be therapeutic. Conclusion It should not be forgotten that ectopic thyroid tissue can be a site for adenoma or papillary carcinoma and thus any watch and wait strategy should be avoided.
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Affiliation(s)
- Vincenzo Consalvo
- Università degli Studi di Salerno, Italy; Collaborator of Clinique du Parc Montpellier, France.
| | | | | | | | | | | | | | | | - Domenico Lombardi
- Hospital of Cava de' Tirreni, Università degli studi di Salerno, Italy.
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Rayess HM, Monk I, Svider PF, Gupta A, Raza SN, Lin HS. Thyroglossal Duct Cyst Carcinoma: A Systematic Review of Clinical Features and Outcomes. Otolaryngol Head Neck Surg 2017; 156:794-802. [DOI: 10.1177/0194599817696504] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective Although thyroglossal duct cysts (TGDCs) are relatively common, malignancies within these lesions are infrequent. As a result, there are no large-scale series describing clinical characteristics. Our objectives were to perform a systematic review of the literature evaluating patient demographics, pathology, management, and prognosis of these patients. Data Sources PubMed, Embase, Cochrane reviews, and Google Scholar were searched for relevant articles. Articles meeting inclusion criteria were reviewed for data detailing epidemiology, treatment, and outcomes. Review Methods Inclusion criteria included English-language articles with original reports on human subjects. Two investigators independently reviewed all articles for the data collected, including epidemiology, treatment, and outcomes. Results Ninety-eight articles comprising 164 patients were included in the final analysis. The mean age at presentation was 39.5 years (9-83 years); 68.3% of patients were female. In total, 73.3% of cases were found on final pathologic analysis. The most common pathology was papillary cancer (92.1%). Of the patients, 98.9% underwent a Sistrunk procedure and 61.0% underwent total thyroidectomy. There was a 4.3% recurrence rate with a mean time to recurrence of 42.1 months from initial treatment. One patient died of TGDC carcinoma, while all other patients were disease free at the time of last follow-up (mean follow-up was 46.1 months). Conclusion TGDC carcinoma is typically diagnosed on final pathology. While management encompasses a Sistrunk procedure, further consideration should be given to thyroidectomy among patients ≥45 years of age and individuals with aggressive disease. TGDC carcinoma harbors an exceedingly low rate of mortality.
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Affiliation(s)
- Hani M. Rayess
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Ian Monk
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Peter F. Svider
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Amar Gupta
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - S. Naweed Raza
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
- Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Ho-Sheng Lin
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
- Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
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Arden RL, Miller LK. Application of Trotter Approach for Large Intralingual Thyroglossal Duct Cyst in an 88-Year-Old Patient. J Oral Maxillofac Surg 2017; 75:1921-1925. [PMID: 28284788 DOI: 10.1016/j.joms.2017.02.007] [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: 01/19/2017] [Revised: 01/26/2017] [Accepted: 02/06/2017] [Indexed: 11/18/2022]
Abstract
Thyroglossal duct cysts (TDCs) are the most common congenital cyst formations in the neck, typically occurring at midline infrahyoid positions in younger patients. Traditional management has used the Sistrunk procedure to minimize recurrence rates. Reports on elderly patients are sparse, and currently only 16 cases have been reported in patients older than 70 years and 4 patients older than 80 years. This report describes the oldest known patient with TDC who had a purely intralingual location requiring a Trotter approach and a Sistrunk procedure for symptomatic management.
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Affiliation(s)
- Richard L Arden
- Chief of Otolaryngology-Head and Neck Surgery, Department of Surgery Division, William Beaumont Hospital, Troy, MI.
| | - Laura K Miller
- Resident, Department of Otolaryngology-Facial Plastic Surgery, Henry Ford Macomb Hospital, Clinton Township, MI
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Chung MS, Baek JH, Lee JH, Choi YJ, Yoon JH, Nam SY, Kim SC, Sung JY, Baek SM, Na DG. Treatment Efficacy and Safety of Ethanol Ablation for Thyroglossal Duct Cysts: A Comparison with Surgery. Eur Radiol 2016; 27:2708-2716. [DOI: 10.1007/s00330-016-4659-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 11/04/2016] [Accepted: 11/16/2016] [Indexed: 10/20/2022]
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Thyroglossal Duct Cyst Carcinomas: A Clinicopathologic Series of 22 Cases with Staging Recommendations. Head Neck Pathol 2016; 11:175-185. [PMID: 27704385 PMCID: PMC5429280 DOI: 10.1007/s12105-016-0757-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 09/21/2016] [Indexed: 10/20/2022]
Abstract
Carcinomas arising from thyroglossal duct remnant cysts (TGDCs) are rare, without well-defined management and staging criteria. All TGDCs (n = 685) diagnosed between 2005 and 2015 were retrospectively reviewed, with 22 carcinomas identified (3.2 % incidence). Twenty-two patients (17 females, 5 males), aged 12-64 years (mean 39.9 years; median 39 years) were identified. An anterior, superior midline neck mass was the presenting symptom in all patients. A cancer diagnosis [all papillary thyroid carcinoma (PTC)] was made after the Sistrunk procedure (SP), with a Bethesda Category V or VI classification preoperatively by fine needle aspiration in 5 of 12 cases tested. A SP was performed in all patients, with total thyroidectomy concurrently (n = 4) or subsequently (n = 12). A selected neck dissection was performed in 5 patients, with metastases found in 3. Of the patients who had a thyroidectomy, synchronous PTC was identified in 6 (thus, 6 of 22 patients had synchronous thyroid gland primaries). This supports an origin from extra-thyroidal remnants (cyst origin) rather than metastatic tumor from a thyroid gland primary. Follow-up radioactive iodine therapy was performed in 13 patients. Metastatic disease to local lymph nodes 57 months after presentation was seen in 1 patient, with all others alive and disease free (mean 3.8 years; range 0.4-10.8 years). The TGDCs ranged from 0.8 to 5 cm (mean 2.3 cm), while the PTCs ranged from 0.1 to 3.8 cm (mean 1.4 cm). All of the tumors were classical PTC, showing a sclerotic and infiltrative pattern, with a capsule present in 11. Lymphovascular invasion was detected in 11; margins were positive in 6. Using currently defined criteria, the patients were separated into AJCC stage group I (n = 21) or II (n = 1). However, if extension into the adipose tissue (n = 11), skeletal muscle (n = 10), or perineural/perivascular tissues (n = 10) were used to stage the patients, interpreted to represent the equivalent of "extrathyroidal extension" (n = 13) as defined for thyroid gland primaries, there would be 15 group I and 7 group III cases. All seven group III patients were ≥45 years. Three of four patients with lymph node metastasis also showed soft tissue extension. In conclusion, TGDC carcinomas (TGDCCa) are uncommon, with all classical PTC. For "microcarcinomas" (≤1 cm), conservative management can be used for patients <45 years (i.e., Sistrunk procedure only); for >1 cm tumors, and due to the high incidence of concurrent papillary carcinoma and higher stage at presentation in older patients, completion thyroidectomy is recommended for patients ≥45 years. Thus, even though a good prognosis can be expected for PTC developing in TGDCs, staging is advocated to more appropriately match therapeutic interventions.
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Akram R, Wiltshire JJ, Wadsley J, Balasubramanian SP. Adult Thyroglossal Duct Carcinoma of Thyroid Epithelial Origin: A Retrospective Observational Study. Indian J Otolaryngol Head Neck Surg 2016; 68:522-527. [PMID: 27833882 DOI: 10.1007/s12070-016-1019-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 09/06/2016] [Indexed: 11/26/2022] Open
Abstract
Thyroglossal duct or cyst carcinoma (TGDCCa) is uncommon. Current treatments follow those of thyroid cancer but controversy exists over the extent of thyroid and lymph node surgery. Our aim was to study the presentation, treatment strategies and clinical outcomes in patients presenting with TGDCCa. Of 637 patients diagnosed with thyroid cancer over 15-years, 4 patients (0.6 %) with TGDCCa were identified. Two patients were diagnosed outside this time period. Details of demographics, presentation, diagnosis, management and outcomes of all 6 patients were reviewed. 5 females and 1 male with a median (range) age of 41 (21-70) years were treated for TGDCCa. Five patients were diagnosed after initial surgery for thyroglossal cyst-cyst excision (n = 2) and Sistrunk's procedure (n = 3). This was followed by a total thyroidectomy (TT) in 4 of these patients. One patient underwent Sistrunk's operation, total thyroidectomy and central neck dissection at the first operation. I131 therapy was used in patients who had TT. Three patients had additional tumour foci in the thyroid. However, lymph node recurrence occurred in 2 patients at 6 and 16 months. At a median follow up of 55 months, all 6 patients were disease free. All patients had papillary TGDCCa and did well with conventional treatment as for thyroid cancer. The extent of treatment required is debatable as half the patients had additional thyroid foci and no patient had clinically or radiologically involved lymph nodes at presentation. A systematic review of published cases will help summarise the existing knowledge base.
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Affiliation(s)
- Rahim Akram
- University of Sheffield, Beech Hill Rd, Sheffield, South Yorkshire S10 2RX, M14 7DN England, UK
| | - Joseph J Wiltshire
- University of Sheffield, Beech Hill Rd, Sheffield, South Yorkshire S10 2RX, M14 7DN England, UK
| | - Jonathan Wadsley
- Weston Park Hospital, Sheffield, Whitham Rd, Sheffield, Sheffield, South Yorkshire S10 2SJ England, UK
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Atmaca S, Çeçen A, Kavaz E. Thyroglossal Duct Cyst in a 3-Month-Old Infant: A Rare Case. Turk Arch Otorhinolaryngol 2016; 54:138-140. [PMID: 29392034 DOI: 10.5152/tao.2016.1636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/14/2016] [Indexed: 11/22/2022] Open
Abstract
Thyroglossal duct cyst (TGDC) is the most common congenital midline neck mass in children. It usually becomes symptomatic following a respiratory tract infection and is usually diagnosed at 5 years of age. Thyroglossal duct cyst is rarely observed in less than 1-year-old infants. In this study, we present a 3-month-old infant with TGDC, who was administered multiple courses of antibiotic therapy for the hyperemic, draining, midline neck mass that had existed since he was 15 days old. Physical examination revealed an infrahyoid midline neck mass measuring 3×3 cm, which moved while swallowing and had a sinus opening in the overlying skin. The patient underwent Sistrunk operation under general anesthesia. Histopathologic examination revealed TGDC. One-year follow-up revealed no recurrence.
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Affiliation(s)
- Sinan Atmaca
- Department of Otorhinolaryngology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ayşe Çeçen
- Department of Otorhinolaryngology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Esra Kavaz
- Department of Otorhinolaryngology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
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Bilateral areolar endoscopic Sistrunk operation: a novel technique for thyroglossal duct cyst surgery. Surg Endosc 2016; 31:1993-1998. [PMID: 27492432 DOI: 10.1007/s00464-016-5137-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/16/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sistrunk operation of the thyroglossal duct is a procedure for the removal of a cyst, the middle part of the hyoid bone and tract towards the foramen caecum. Unavoidably, this procedure results in a scar on the skin in the neck area. By performing a bilateral areolar endoscopic Sistrunk operation, this study is the first to develop a procedure that can solve the aesthetic problem. This operation results in both an excellent cosmetic result and the successful treatment of TGDC. METHODS A three-port technique was performed in this operation: 10-mm port for 30°, 10-mm laparoscope, 5-mm port for the instrument at the left circumareolar area and 5-mm port located at the right circumareolar area. Insufflation pressure of CO2 gas was set at 6 mm Hg. The surgical working space was located over the breast tissue and pectoralis muscles, towards the anterior neck to the hyoid bone. The steps employed for resection were similar to a conventional Sistrunk operation using standard laparoscopic instruments and hook scissors. RESULTS A series of 11 patients were successfully treated using this novel technique with neither conversion to open surgery nor surgical complications. Average operative time was 88.54 min (ranging from 60 to 130 min). Average blood loss was 35 mL. (ranging from 15 to 67 mL). Patients were discharged in an average of 2.36 days after the procedure (ranging from 2 to 3 days). CONCLUSION This novel technique for TGDC Sistrunk surgery using an areolar approach is feasible, safe and effective. The benefit of this technique is the cosmetic result, which leaves no scarring on the neck after wound healing and may provide a new method for optimal aesthetic results.
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Al-Thani H, El-Menyar A, Sulaiti MA, El-Mabrok J, Hajaji K, Elgohary H, Asim M, Taha I, Tabeb A. Presentation, Management, and Outcome of Thyroglossal Duct Cysts in Adult and Pediatric Populations: A 14-Year Single Center Experience. Oman Med J 2016; 31:276-83. [PMID: 27403240 DOI: 10.5001/omj.2016.54] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES A thyroglossal duct cyst (TDC) is a frequent congenital midline anomaly of the neck that usually manifests during the first decade of life. We aimed to describe the presentation, management, and outcome of TDC in pediatric and adult cases. METHODS A retrospective observational analysis was conducted for all patients diagnosed and treated for TDC between 2000 and 2014 in a single center in Qatar. Data included patients' demographics, presentations, preoperative investigations, anesthesia type, histopathological findings, surgical management, recurrences, and complications. RESULTS We identified 102 patients, of which 57% were males. The mean age of patients was 20.2±15.6 years. A bimodal distribution of TDC has been observed, which peaked between the ages of 6-13 years and at ≥19 years. The preoperative evaluation mainly includes ultrasonography (66%), thyroid function test (44%), and fine-needle aspiration cytology (10%). The median size of the cyst was 25 (2-60) mm. Patients mainly presented with an asymptomatic midline neck mass at or below the hyoid bone (82%), followed by fistula (9%), infection (2%), and dysphagia (2%). Eighty-nine cases were identified preoperatively as TDC. The histopathological findings confirmed TDC with hyoid bone in 61 cases, and TDC alone in 38 cases. Eighty patients underwent the Sistrunk procedure while excision of TDC alone was observed in 18 cases. Five cases of recurrent disease were also treated. Adults had a greater median cyst size (30 (9-60) vs. 22 (2-55) mm; p = 0.005) and required prolonged operation time (69 (1-169) vs. 32.5 (1-140) mins;
p = 0.004) compared to the pediatric group. CONCLUSION The occurrence of TDC shows a bimodal age distribution. Preoperative evaluation and time for surgery vary whereas clinical presentations, surgical management, and postoperative outcomes are comparable among adult and pediatric groups. Ultrasonography is the preferred diagnostic modality, and the Sistrunk procedure remains the primary choice of treatment.
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Affiliation(s)
- Hassan Al-Thani
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Ayman El-Menyar
- Clinical Research, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar; Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
| | | | | | - Khairi Hajaji
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Hesham Elgohary
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Asim
- Clinical Research, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar
| | - Ibrahim Taha
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
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Abstract
Thyroglossal duct cysts (TDCs) are one of the most common congenital cervical masses that develop in children. Double TDCs are reported in very few patients in the literature. However, the authors did not come across any thyroglossal cyst with double duct in the English literature. A 35-year female patient consulted to authors' clinic with complaints of a swelling localized on the left side of the neck and recurrent purulent discharge. A Sistrunk operation was planned and during the operation, 2 fistula tracts, both terminated in the hyoid bone, were exposed.Usually, only one fistulous tract opens onto the skin; however, in the authors' patient, the authors encountered TDC with double ducti. To authors' knowledge, no similar patients were reported in the literature.
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A Clinicopathologic Series of 685 Thyroglossal Duct Remnant Cysts. Head Neck Pathol 2016; 10:465-474. [PMID: 27161104 PMCID: PMC5082048 DOI: 10.1007/s12105-016-0724-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
The clinical features of thyroglossal duct remnant cysts (TGDC) have been well described, however the histopathologic aspects of these lesions have not been addressed in a detailed manner. In particular, there has been no large community practice based series evaluating TGDC histologically compared with management outcomes. A retrospective review of all TGDC diagnosed between 2005 and 2015 was performed. Six hundred eighty-five patients were identified (344 males; 341 females). Age at presentation was bimodal (first and fifth decades) and ranged from 0.8 to 87 years (mean 31.3 years). Males predominate in children (150:111); females in adults (230:194). Patients presented most frequently with a mobile midline neck mass in an infrahyoid location. An associated skin fistula (n = 67) was twice as common in pediatric as adult patients. The average cyst size was 2.4 cm (range 0.4-9.9 cm) by imaging studies and 2.6 cm (range 0.2-8.5 cm) by pathologic examination; pediatric patients had smaller cysts (mean 2.1 cm) than adults (mean 2.8 cm). Histologically, 257 (38 %) TGDC were lined by respiratory epithelium alone, 68 (10 %) squamous epithelium alone, 347 (51 %) exhibited both respiratory and squamous epithelium, and 13 (1 %) had no identifiable epithelial lining. Four hundred eighty-four (71 %) TGDC had associated thyroid gland tissue present within the cyst wall (n = 282), skeletal muscle (n = 71), adipose tissue (n = 34), or a combination of these sites (n = 97). The hyoid bone was identified in 647 (grossly and/or histologically), and absent in 38. Surgical management consisted of Sistrunk procedure (n = 647), cystectomy (n = 31), or thyroidectomy/thyroid lobectomy (n = 7). Treatment related complications were observed in 6 patients, which included vocal cord damage, seroma, and hematoma. Recurrences developed in 20 (3 %) patients, 14 of whom were managed initially by cystectomy. Papillary thyroid carcinoma was identified in 22 (3.2 %) TGDC. In summary, TGDC show a bimodal peak in the 1st and 5th decades, commonly presenting as a midline cervical lesion below the hyoid bone, associated with a skin fistula in 10 %. Histologically TGDC are most commonly lined by a combination of respiratory and squamous epithelium. Thyroid gland tissue is identified in 71 % of cases (0.45 cm mean size), although not limited to the cyst wall, but present in the surrounding soft tissues. Rare TGDC may harbor malignancy (3.2 %). TGDC are most effectively managed by Sistrunk procedure rather than excision, which carries low rates of complications (1 %) and recurrence (3 %).
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Thyroglossal Duct Papillary Thyroid Carcinoma and Synchronous Lingual Thyroid Atypia. Case Rep Otolaryngol 2016; 2016:3975924. [PMID: 27119036 PMCID: PMC4826937 DOI: 10.1155/2016/3975924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 03/09/2016] [Accepted: 03/14/2016] [Indexed: 12/29/2022] Open
Abstract
Thyroglossal duct and lingual thyroid ectopic lesions are exceedingly rare synchronous findings. Papillary thyroid carcinoma of these ectopic thyroid sites is well understood but still a rare finding. This case points to some management nuances in regard to ectopic thyroid screening with imaging and also shows the effectiveness of minimally invasive transoral robotic surgery for lingual thyroid.
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Chang YS, Su HH, Ho SP. Adenosquamous carcinoma arising from a thyroglossal duct cyst: A case report. Oncol Lett 2016; 11:2668-2672. [PMID: 27073536 DOI: 10.3892/ol.2016.4262] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 01/26/2016] [Indexed: 11/05/2022] Open
Abstract
The current study describes a case of adenosquamous carcinoma originating from a thyroglossal duct cyst (TGDC). A 77-year-old man presented with an asymptomatic mass in the left mid-neck, which was soft and mobile on palpation. Fine-needle aspiration was performed, but cytology did not detect any malignant cells. Computed tomography demonstrated a single cystic lesion in the left lobe of the thyroid gland; therefore, surgery was performed on the suspected thyroid cyst. However, it was identified intraoperatively that the lesion was separated from the thyroid gland and instead adhered to an additional hyoid bone; therefore, the Sistrunk procedure was performed. Histopathological examination of the resected tumor confirmed the diagnosis of adenosquamous carcinoma originating from a TGDC. Carcinoma arising from a TGDC is rare, and accounts for 1% of all TGDC cases. The most common subtype of carcinoma associated with TGDC is papillary carcinoma, whilst adenosquamous carcinoma developing from a TGDC is extremely rare, with only one case currently reported in the literature. Although a consensus for the management of this disease has not yet been established, adequate surgical excision with long-term follow-up is currently the preferred treatment.
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Affiliation(s)
- Yu-Sung Chang
- Department of Otolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
| | - Hsin-Hao Su
- Department of Otolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
| | - Szu-Pei Ho
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
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Dbab L, Nouri H, Iguelouane N, Rochdi Y, Aderdour L, Raji A. [Papillary carcinoma on thyroglossal duct cyst: report of two cases]. Pan Afr Med J 2016; 22:105. [PMID: 26848352 PMCID: PMC4732646 DOI: 10.11604/pamj.2015.22.105.7006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/12/2015] [Indexed: 12/03/2022] Open
Abstract
L'objectif de ce travail est de présenté deux cas de carcinomes papillaire sur kystes du tractus thyréoglosse (KTT) et d'exposer notre attitude thérapeutique. Il s'agit de deux patientes, une âgée de 30 ans et l'autre de 45 ans, qui ont été opéré dans notre centre. Le diagnostic du carcinome papillaire sur KTT a été retenu après étude anatomopathologique du kyste après exérèse selon la technique de Sistrunk. Une thyroïdectomie totale suivie d'une irathérapie et d'une hormonothérapie freinatrice a été réalisé chez l'une des patientes, pour l'autre une thyroïdectomie totale associée à une hormonothérapie freinatrice a été préconisé. L'évolution été favorable après un recule de 4 ans pour la première patiente et de 2 ans pour la deuxième. La thyroïdectomie totale après exérèse complète du KTT est le traitement recommandé pour le carcinome papillaire sur KTT. Il a été démontré qu'un cancer latent de la thyroïde peut être développé même après des années après l'exérèse du KTT. Le traitement du carcinome papillaire sur KTT est bien codifié, permettant un excellent pronostic.
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Affiliation(s)
- Lamia Dbab
- Service d'ORL et de Chirurgie Cervico-faciale, CHU Mohammed VI, Marrakech, Maroc
| | - Hassan Nouri
- Service d'ORL et de Chirurgie Cervico-faciale, CHU Mohammed VI, Marrakech, Maroc
| | - Nassim Iguelouane
- Service d'ORL et de Chirurgie Cervico-faciale, CHU Mohammed VI, Marrakech, Maroc
| | - Youssef Rochdi
- Service d'ORL et de Chirurgie Cervico-faciale, CHU Mohammed VI, Marrakech, Maroc
| | - Lahcen Aderdour
- Service d'ORL et de Chirurgie Cervico-faciale, CHU Mohammed VI, Marrakech, Maroc
| | - Abdelaziz Raji
- Service d'ORL et de Chirurgie Cervico-faciale, CHU Mohammed VI, Marrakech, Maroc
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Huang Z, Guo W, Zhou B, Chen X. Minimally Invasive Endoscopic Surgery of Thyroglossal Duct Cysts. J Laparoendosc Adv Surg Tech A 2015; 25:892-6. [PMID: 26575246 DOI: 10.1089/lap.2015.0285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Thyroglossal duct cysts (TGDCs) may cause cosmetic defects or more serious impairments if left untreated. Our study was designed to examine the potential advantage of endoscopic surgery performed on TGDCs, especially the ability to completely resect the branches and to affect the cosmetic appearance. PATIENTS AND METHODS Thirty-two patients from Beijing Tongren Hospital, Beijing, China, diagnosed with TGDCs were selected. Seventeen patients with TGDCs underwent traditional Sistrunk's surgery, and 15 patients underwent endoscopic cystectomy. RESULTS All patients had complete resection and were followed up from 6 months to 4 years. None had a recurrence after endoscopic resection. However, patients in the traditional surgery group had a 5.9% (1/17) rate of recurrence. The incision length was approximately 2.1 cm in the endoscopic group compared with 5.2 cm in the traditional group. The mean time for the endoscopic operation was 97.7 minutes compared with 51.6 minutes in the traditional surgical procedure. The average length of hospital stay was 6.7 days in the endoscopic group compared with 9.7 days in the traditional group. CONCLUSIONS Endoscope-assisted small-incision thyroglossal duct cystectomy is an efficient method. It causes fewer cosmetic defects and also decreases operative time. It will likely become the new standard procedure for patients with TGDCs.
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Affiliation(s)
- Zhigang Huang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University , Beijing, China .,Key Laboratory of Otolaryngology Head and Neck Surgery ( Capital Medical University ), Ministry of Education, Beijing, China
| | - Wei Guo
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University , Beijing, China .,Key Laboratory of Otolaryngology Head and Neck Surgery ( Capital Medical University ), Ministry of Education, Beijing, China
| | - Bing Zhou
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University , Beijing, China .,Key Laboratory of Otolaryngology Head and Neck Surgery ( Capital Medical University ), Ministry of Education, Beijing, China
| | - Xiaohong Chen
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University , Beijing, China .,Key Laboratory of Otolaryngology Head and Neck Surgery ( Capital Medical University ), Ministry of Education, Beijing, China
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Sato T, Suenaga H, Igarashi M, Hoshi K, Takato T. Rare case of external dental fistula of the submental region misdiagnosed as inverted follicular keratosis and thyroglossal duct cyst. Int J Surg Case Rep 2015; 16:39-43. [PMID: 26413920 PMCID: PMC4643351 DOI: 10.1016/j.ijscr.2015.08.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 08/28/2015] [Accepted: 08/29/2015] [Indexed: 11/29/2022] Open
Abstract
A relatively rare case of the cutaneous sinus tract in the submental region, derived from the lower second molar, was misdiagnosed as inverted follicular keratosis and thyroglossal duct cyst. The patient previously underwent punch resection under local anesthesia, resulting in a histopathological diagnosis of inverted follicular keratosis. Computed tomography (CT) and fistulography indicated that the cutaneous lesion was linked to the periapex of the left mandibular second molar. Diagnostic imaging is essential in ensuring accurate assessment of the cause of cutaneous sinus tract.
Introduction Odontogenic cutaneous sinus tract is a relatively rare occurrence that can be complicated to diagnose. The presence of a cutaneous lesion is often not even partly associated with a dental etiology because of the less frequency of occurrence in the case of dental symptoms. Consequently, the underlying dental cause is often missed leading to inappropriate diagnosis and treatment. Case presentation Here, we report the case of a 45-year-old man who presented with a persistent lesion of the cervical region. At the time of presentation, the lesion had been present for approximately one year with a gradual increase in size but no specific symptoms. The patient had previously undergone punch resection under local anesthesia, which resulted in a histopathological diagnosis of inverted follicular keratosis. A diagnosis was made of an odontogenic cutaneous sinus tract secondary to chronic apical periodontitis of the left mandibular second molar. Discussion Cutaneous sinus tract in the face and neck is most likely to develop intraorally. Root canal treatment or surgical extractions are the common treatment choices. A previously reported review of 137 cases found that 106 (77%) were treated by extraction and 27 (20%) were treated by surgical or conservative nonsurgical endodontic therapy. Conclusion Early diagnosis of cutaneous sinus tract using proper aid is responsible for shortening the treatment duration and avoiding unnecessary treatment.
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Affiliation(s)
- Toshihisa Sato
- Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital, Japan
| | - Hideyuki Suenaga
- Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital, Japan.
| | - Masaki Igarashi
- Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital, Japan
| | - Kazuto Hoshi
- Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital, Japan
| | - Tsuyoshi Takato
- Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital, Japan
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Taimisto I, Mäkitie A, Arola J, Klockars T. Thyroglossal duct cyst: patient demographics and surgical outcome of 159 primary operations. Clin Otolaryngol 2015; 40:496-9. [DOI: 10.1111/coa.12418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 11/27/2022]
Affiliation(s)
- I. Taimisto
- Department of Otorhinolaryngology - Head and Neck Surgery; Helsinki University Central Hospital and University of Helsinki; Helsinki Finland
| | - A. Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery; Helsinki University Central Hospital and University of Helsinki; Helsinki Finland
| | - J. Arola
- Department of Pathology; Haartman Institute; University of Helsinki and HUSLAB; Helsinki University; Helsinki Finland
| | - T. Klockars
- Department of Otorhinolaryngology - Head and Neck Surgery; Helsinki University Central Hospital and University of Helsinki; Helsinki Finland
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Does Papillary Carcinoma of Thyroglossal Duct Cyst Develop De Novo? Case Rep Otolaryngol 2015; 2015:382760. [PMID: 26351606 PMCID: PMC4553182 DOI: 10.1155/2015/382760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/05/2015] [Indexed: 11/17/2022] Open
Abstract
Backround. Thyroglossal duct cyst (TDC) is a developmental abnormality of the thyroid gland. Due to embryological remnants of thyroid tissue located in the TDC, the same malignant tumors that develop in the thyroid gland can also develop in the TDC. Methods. We present the unique case of a 39-year-old female with simultaneous de novo papillary carcinoma in a TDC and the thyroid gland. Results. With the suspicion of simultaneous papillary carcinoma in the TDC and the thyroid gland, Sistrunk procedure with total thyroidectomy and central neck exploration was performed. Conclusion. The clinician should have a high index of suspicion upon encountering papillary carcinoma of the TDC to differentiate de novo papillary carcinoma in the TDC from those originating from the thyroid gland, because papillary carcinoma in TDC may originate from an occult thyroid papillary carcinoma.
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Woo SH, Park JJ, Hong JC, Wang SG, Park GC, Eun YG, Kim JP, Jeong HS. Endoscope-assisted transoral removal of a thyroglossal duct cyst using a frenotomy incision: A prospective clinical trial. Laryngoscope 2015; 125:2730-5. [DOI: 10.1002/lary.25508] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/02/2015] [Accepted: 06/22/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Seung Hoon Woo
- Department of Otolaryngology; Gyeongsang National University; Jinju Korea
- Institute of Health Sciences, Gyeongsang National University; Jinju Korea
| | - Jung Je Park
- Department of Otolaryngology; Gyeongsang National University; Jinju Korea
| | - Jong Chul Hong
- Department of Otorhinolaryngology-Head and Neck Surgery; Dong-A University Hospital; Busan Korea
| | - Soo-Geun Wang
- Department of Otorhinolaryngology-Head and Neck Surgery; Busan National University School of Medicine; Busan Korea
| | - Gi Cheol Park
- Department of Otolaryngology; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine; Changwon Korea
| | - Young Gyu Eun
- Department of Otolaryngology; Kyung Hee University School of Medicine; Seoul Korea
| | - Jin Pyeong Kim
- Department of Otolaryngology; Gyeongsang National University; Jinju Korea
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery; Sungkyunkwan University School of Medicine, Samsung Medical Center; Seoul Korea
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