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Paladini I, Schirò S, Ledda RE, Leo L, Milanese G, Epifani E, Andreone A, Capurri G, Fantoni M, Gemignani A, Gritti A, Sesenna E, Menozzi R. Percutaneous injection of sclerosant agents as an effective treatment for cystic malformations of the head and neck. Oral Maxillofac Surg 2024; 28:809-818. [PMID: 38261079 DOI: 10.1007/s10006-024-01210-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/14/2024] [Indexed: 01/24/2024]
Abstract
PURPOSE To evaluate the clinical and aesthetic outcome of percutaneous injection of sclerosant agents to treat head and neck cystic malformations (HNCM) and to assess their recurrence rate based on histology and site. METHODS Fifty-four subjects (mean age 46 years) with HNCM treated by percutaneous injection of sclerosant agents between January and December 2017 were included. Imaging and clinical data before and after the procedure were collected. Quality of Life Index, Pain Visual Analogue Scale, and Aesthetic Scale scores were measured to assess clinical and aesthetic outcomes. A size reduction of ≥ 70% assessed through the visual scale was considered significant. RESULTS Of the 54 HNCM, there were 26 (48%) lymphatic malformations (LM), 13 (24%) salivary epithelial duct cysts of the parotid gland, 12 (22%) salivary mucoceles, and 3 (5%) branchial cysts. A significant size reduction and a satisfactory clinical-aesthetic outcome were observed in all types of LM. The number of reinterventions was significantly associated with the number of lesions (p < 0.001). The lowest number of interventions was observed in macrocystic lymphatic malformations (average of 1.2 interventions). All salivary epithelial duct cysts showed a significant reduction in size, a satisfactory clinical-aesthetic outcome, and an average of 1.16 interventions per patient. Mucoceles had a worse response, with only 3/14 patients showing a satisfactory and long-lasting clinical outcome (average of 1.16 interventions). Treatment of branchial cysts showed the worst outcome with a limited clinical response (3/3). CONCLUSION Percutaneous injection of sclerosant agents may be considered as a first-line treatment for LM and salivary epithelial duct cysts.
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Affiliation(s)
- Ilaria Paladini
- Unit of Interventional Radiology, Diagnostic Department, Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Silvia Schirò
- Department of Medicine and Surgery (DiMec), University of Parma, Via gramsci 14 (43126), Parma, Italy.
| | - Roberta Eufrasia Ledda
- Department of Medicine and Surgery (DiMec), University of Parma, Via gramsci 14 (43126), Parma, Italy
| | - Ludovica Leo
- Department of Medicine and Surgery (DiMec), University of Parma, Via gramsci 14 (43126), Parma, Italy
| | - Gianluca Milanese
- Unit of "Scienze Radiologiche", Department of Medicine and Surgery (DiMeC), University Hospital of Parma, Parma, Italy
| | - Enrico Epifani
- Unit of Interventional Radiology, Diagnostic Department, Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Andrea Andreone
- Unit of Interventional Radiology, Diagnostic Department, Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Giulia Capurri
- Unit of Interventional Radiology, Diagnostic Department, Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Matteo Fantoni
- Neuroradiology Unit, Diagnostic Department, University Hospital of Parma, Via Volturno 39, 43125, Parma, Italy
| | - Andrea Gemignani
- Department of Medicine and Surgery (DiMec), University of Parma, Via gramsci 14 (43126), Parma, Italy
| | - Alessandro Gritti
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma,, Parma, Italy
| | - Enrico Sesenna
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Roberto Menozzi
- Interventional Neuroradiology Unit, Diagnostic Department, University Hospital of Parma, Via Volturno 39, 43125, Parma, Italy
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Sabra TA, Mohamed AA, Hussien MT, Abdelmohsen SM. Suprasternal dermoid sinus: A case report. Int J Surg Case Rep 2024; 119:109785. [PMID: 38781842 PMCID: PMC11141438 DOI: 10.1016/j.ijscr.2024.109785] [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: 03/17/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Congenital anomalies in the neck region, such as dermoid sinuses, pose diagnostic challenges in pediatrics. Surgical excisions are vital to prevent complications. PRESENTATION OF CASE A 7-month-old male infant had presented with a congenital suprasternal dermoid sinus, which had been evident since birth. Imaging confirmed the diagnosis, prompting surgical intervention under general anesthesia. A delicate excision was performed, guided by a methylene blue dye injection, followed by histopathological confirmation. DISCUSSION Dermoid sinuses typically manifest as cutaneous pits or sinus tracts, with a left-sided predominance and a female predilection. An accurate diagnosis relies on clinical examination and imaging studies to delineate the anomaly. Surgical excision remains crucial to prevent recurrence and complications. CONCLUSION This case reaffirms the necessity of prompt and accurate diagnosis followed by surgical intervention for managing congenital dermoid sinuses. Ongoing research and collaborative studies are needed to further refine management strategies and improve outcomes for patients with these anomalies, particularly when presenting in atypical locations.
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Affiliation(s)
| | - Ahmed Amgad Mohamed
- Faculty of Medicine, Helwan University, Cairo, Egypt; Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA.
| | | | - Sarah Magdy Abdelmohsen
- Pediatric Surgery Department, Department of General Surgery, Aswan University, Aswan, Egypt.
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Chung M, Ton L, Lee AY. Forget Me Not: Incidental Findings on Breast MRI. JOURNAL OF BREAST IMAGING 2024:wbae023. [PMID: 38758984 DOI: 10.1093/jbi/wbae023] [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: 09/02/2023] [Indexed: 05/19/2024]
Abstract
With the growing utilization and expanding role of breast MRI, breast imaging radiologists may encounter an increasing number of incidental findings beyond the breast and axilla. Breast MRI encompasses a large area of anatomic coverage extending from the lower neck to the upper abdomen. While most incidental findings on breast MRI are benign, identifying metastatic disease can have a substantial impact on staging, prognosis, and treatment. Breast imaging radiologists should be familiar with common sites, MRI features, and breast cancer subtypes associated with metastatic disease to assist in differentiating malignant from benign findings. Furthermore, detection of malignancies of nonbreast origin as well as nonmalignant, but clinically relevant, incidental findings can significantly impact clinical management and patient outcomes. Breast imaging radiologists should consistently follow a comprehensive search pattern and employ techniques to improve the detection of these important incidental findings.
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Affiliation(s)
- Maggie Chung
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Lauren Ton
- School of Medicine, University of California, San Francisco, CA, USA
| | - Amie Y Lee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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Trovalusci E, Pizzolon C, Tesser S, Doratiotto S, Gobbi D, Midrio P. Incidental finding of thyroglossal duct cyst in a neonate during endotracheal intubation: a case report. BMC Pediatr 2024; 24:264. [PMID: 38654283 PMCID: PMC11040807 DOI: 10.1186/s12887-024-04742-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Thyroglossal Duct Cyst (TDC) is a common lesion of the midline neck, originating from an incomplete involution of the thyroglossal duct. It is typically observed in pre-scholar patients and surgery is the treatment of choice to prevent infections. Here reported a case of incidental diagnosis in a newborn patient. CASE PRESENTATION a 3-week-old male baby was admitted to our hospital for weight loss and projectile vomits after breastfeeding. After a diagnosis of hypertrophic pyloric stenosis, the baby underwent pyloromyotomy. During the endotracheal tube placement, the anesthetist noticed the presence of a midline neck mass. The suspect of TDC was confirmed by an intraoperative ultrasound, so, despite the age of the patient, we proceeded with the excision of the lesion according to Sistrunk's procedure to avoid future complications and anesthesia. CONCLUSIONS even if TDC is a common lesion of pediatric patients, anecdotical neonatal cases were described in the literature, all of them symptomatic. An accurate physical examination and ultrasound are essential diagnostic tools to distinguish TDC from other middle neck lesions, particularly ectopic thyroidal tissue. Sistrunk's procedure is the most effective surgical approach. When diagnosis is made in a newborn, we suggest postponing surgery, unless the baby requires general anesthesia for other surgical procedures, such as in our case.
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Affiliation(s)
- Emanuele Trovalusci
- Pediatric Surgery Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy.
- Pediatric Surgery Unit, Ospedale Ca' Foncello, Treviso, Italy.
| | - Carlo Pizzolon
- Pediatric Surgery Unit, Ospedale Ca' Foncello, Treviso, Italy
| | - Silvia Tesser
- Pediatric Anesthesiology Unit, Ospedale Ca' Foncello, Treviso, Italy
| | | | - Dalia Gobbi
- Pediatric Surgery Unit, Ospedale Ca' Foncello, Treviso, Italy
| | - Paola Midrio
- Pediatric Surgery Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy.
- Pediatric Surgery Unit, Ospedale Ca' Foncello, Treviso, Italy.
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Fernández Figueras MT, Alzoghby-Abi Chaker J, Fernandez-Parrado M, García Herrera A, Garrido M, Idoate Gastearena MÁ, Llamas-Velasco M, Monteagudo C, Onrubia J, Pérez Muñoz N, Ríos-Martín JJ, Rodríguez Peralto JL, Rozas Muñoz E, Sanmartín O, Santos-Briz Á, Saus C, Suárez Peñaranda JM, Velasco Benito V, Beato Merino MJ, Fernandez-Flores Á. [Main Types of Cysts in Dermatopathology: Part 2]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2024; 57:97-110. [PMID: 38599743 DOI: 10.1016/j.patol.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/23/2023] [Indexed: 04/12/2024]
Abstract
This is the second article in a two-part series published in this journal, in which we examine the histopathological characteristics, as well as the differential diagnosis, of the main entities that present as cystic and pseudocystic structures in cutaneous biopsy. In this second article, we address ciliated cutaneous cysts, branchial cysts, Bartholin's cysts, omphalomesenteric cysts, thymic cysts, thyroglossal duct cysts, synovial cysts, and median raphe cysts, as well as mucocele, ganglion, and auricular and digital myxoid pseudocysts.
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Affiliation(s)
- María Teresa Fernández Figueras
- Servicio de Anatomía Patológica, Hospital Universitari General de Catalunya, Grupo QuironSant Cugat del Vallès, Barcelona, España
| | | | | | | | - María Garrido
- Servicio de Anatomía Patológica, Hospital Universitario 12 de Octubre, Madrid, España
| | | | - Mar Llamas-Velasco
- Servicio de Dermatología, Hospital Universitario de la Princesa, Madrid, España
| | - Carlos Monteagudo
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia, Valencia, España
| | - José Onrubia
- Servicio de Anatomía Patológica, Hospital Universitario San Juan de Alicante, Alicante, España
| | - Noelia Pérez Muñoz
- Servicio de Anatomía Patológica, Hospital Universitari General de Catalunya, Grupo QuironSant Cugat del Vallès, Barcelona, España
| | - Juan José Ríos-Martín
- Servicio de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, España
| | | | | | - Onofre Sanmartín
- Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - Ángel Santos-Briz
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Salamanca, Salamanca, España
| | - Carles Saus
- Servicio de Anatomía Patológica, Hospital Universitario Son Espases, Palma de Mallorca, España
| | | | - Verónica Velasco Benito
- Servicio de Anatomía Patológica, Hospital Universitario de Cruces, Barakaldo, Vizcaya, España
| | | | - Ángel Fernandez-Flores
- Servicio de Anatomía Patológica, Hospital Universitario El Bierzo, Ponferrada, León, España.
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Lewis AJ, Rammohankumar K, Kini H, Boaz K. Parasitic colloid cyst: A diagnostic dilemma. J Oral Maxillofac Pathol 2024; 28:321-324. [PMID: 39157826 PMCID: PMC11329091 DOI: 10.4103/jomfp.jomfp_162_23] [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: 04/03/2023] [Revised: 05/12/2023] [Accepted: 06/19/2023] [Indexed: 08/20/2024] Open
Abstract
The pathologies of the neck are varied and at times may cause a diagnostic dilemma for the pathologist. In this report, we present a case of a 32-year-old man with a slow-growing nodular swelling in the right neck region, which was diagnosed as a simple colloid cyst arising in a parasitic thyroid nodule. Simple colloid cysts are cysts that develop due to impaired accumulation of thyroglobulin in inactive follicles. Most thyroid-related pathologies occur as midline swellings. However, the present case was unique due to its location with no connection to the thyroid gland. This case report describes the diagnostic process and adds insight into the pathology of a colloid cyst.
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Affiliation(s)
- Amitha J. Lewis
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - K Rammohankumar
- Lead Consultant Maxillofacial Surgeon, Nanthan Hospital, Krishnagiri, Tamil Nadu, India
| | - Hema Kini
- Department of Pathology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karen Boaz
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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7
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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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Dosemane D, Khadilkar MN, Praneetha P. Cervical thymic cyst ? A Rare Neck Swelling in an Adolescent. Indian J Otolaryngol Head Neck Surg 2024; 76:1344-1346. [PMID: 38440647 PMCID: PMC10909014 DOI: 10.1007/s12070-023-04324-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/25/2023] [Indexed: 03/06/2024] Open
Abstract
Cystic neck masses in adolescents pose a diagnostic challenge as they be neoplastic or non-neoplastic, congenital, inflammatory, or infectious. Detailed history and examination, anatomical location of the lesion may help narrow down the differential diagnosis of such masses. Cervical thymic cysts contribute to less than 1% cystic lesions in the neck. We present one such case and our management strategy.
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Affiliation(s)
- Deviprasad Dosemane
- Department of Otorhinolaryngology and Head & Neck Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Meera Niranjan Khadilkar
- Department of Otorhinolaryngology and Head & Neck Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Puvvula Praneetha
- Department of Otorhinolaryngology and Head & Neck Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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9
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Branstetter BF, Fernandez A. Arrested Descent of the Thyroid: A New Manifestation of Abnormal Thyroid Embryology. Laryngoscope 2024; 134:995-997. [PMID: 37338100 DOI: 10.1002/lary.30831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/27/2023] [Accepted: 06/08/2023] [Indexed: 06/21/2023]
Abstract
In this article, we review the normal embryology of the thyroid gland, categorize the ways in which this embryology can fail, and describe how those failures manifest clinically and radiologically. Finally, we describe a new manifestation of abnormal thyroid embryology. Laryngoscope, 134:995-997, 2024.
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Affiliation(s)
- Barton F Branstetter
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A
| | - Annella Fernandez
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
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10
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Brahmbhatt S, Overfield CJ, Rhyner PA, Bhatt AA. Imaging of the Posttreatment Head and Neck: Expected Findings and Potential Complications. Radiol Imaging Cancer 2024; 6:e230155. [PMID: 38276904 PMCID: PMC10825710 DOI: 10.1148/rycan.230155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
Interpretation of posttreatment imaging findings in patients with head and neck cancer can pose a substantial challenge. Malignancies in this region are often managed through surgery, radiation therapy, chemotherapy, and newer approaches like immunotherapy. After treatment, patients may experience various expected changes, including mucositis, soft-tissue inflammation, laryngeal edema, and salivary gland inflammation. Imaging techniques such as CT, MRI, and PET scans help differentiate these changes from tumor recurrence. Complications such as osteoradionecrosis, chondroradionecrosis, and radiation-induced vasculopathy can arise because of radiation effects. Radiation-induced malignancies may occur in the delayed setting. This review article emphasizes the importance of posttreatment surveillance imaging to ensure proper care of patients with head and neck cancer and highlights the complexities in distinguishing between expected treatment effects and potential complications. Keywords: CT, MR Imaging, Radiation Therapy, Ear/Nose/Throat, Head/Neck, Nervous-Peripheral, Bone Marrow, Calvarium, Carotid Arteries, Jaw, Face, Larynx © RSNA, 2024.
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Affiliation(s)
- Sneh Brahmbhatt
- From the Department of Radiology, Mayo Clinic, 4500 San Pablo Rd,
Cannaday Building and Davis Building, Jacksonville, FL 32224
| | - Cameron J. Overfield
- From the Department of Radiology, Mayo Clinic, 4500 San Pablo Rd,
Cannaday Building and Davis Building, Jacksonville, FL 32224
| | - Patricia A. Rhyner
- From the Department of Radiology, Mayo Clinic, 4500 San Pablo Rd,
Cannaday Building and Davis Building, Jacksonville, FL 32224
| | - Alok A. Bhatt
- From the Department of Radiology, Mayo Clinic, 4500 San Pablo Rd,
Cannaday Building and Davis Building, Jacksonville, FL 32224
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11
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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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12
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Chiang JJY, Tan BWS, Chua AJK, Ong LY, Tan HKK. Surgical management of thyroglossal cysts: 10-year experience of a tertiary paediatric surgical unit. Singapore Med J 2023:386978. [PMID: 37929556 DOI: 10.4103/singaporemedj.smj-2019-111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- Jayne Jie Yi Chiang
- Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore
| | | | - Andy Jian Kai Chua
- Department of Otolaryngology, KK Women's and Children's Hospital, Singapore
| | - Lin Yin Ong
- Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore
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13
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Harrison I, Mojica R, Gurnani P, Lavery MJ, Saikaly SK. Anterior Midline Neck Mass in an Adolescent. J Pediatr 2023; 259:113471. [PMID: 37182657 DOI: 10.1016/j.jpeds.2023.113471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/22/2023] [Indexed: 05/16/2023]
Affiliation(s)
- Iris Harrison
- University of Florida College of Medicine, Gainesville, Florida
| | - Rafael Mojica
- Department of Dermatology, University of Florida, Gainesville, Florida
| | - Pooja Gurnani
- Department of Dermatology, University of Florida, Gainesville, Florida
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14
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D'Arco F, Lee P, Siddiqui A, Nash R, Ugga L. Radiologic diagnosis of non-traumatic paediatric head and neck emergencies. Pediatr Radiol 2023; 53:768-782. [PMID: 36481939 DOI: 10.1007/s00247-022-05556-8] [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: 08/24/2022] [Revised: 10/18/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Abstract
Imaging plays a crucial role in evaluating paediatric patients with non-traumatic head and neck lesions in an emergency setting because clinical manifestations of these entities can overlap. For this reason, radiologists must be familiar with the clinical and imaging findings of prevalent paediatric head and neck emergencies. In this review, we present techniques and imaging clues for common complications of pathological processes in the paediatric head and neck, with a focus on the clinical scenario as a starting point for the radiologic approach.
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Affiliation(s)
- Felice D'Arco
- Department of Radiology, Neuroradiology Unit, Great Ormond Street Hospital, London, UK
| | - Philippa Lee
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - Ata Siddiqui
- Radiology Department, Guy's and St. Thomas' NHS Foundation Trust, London, UK
- Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Robert Nash
- Ear, Nose and Throat Department, Great Ormond Street Hospital, London, UK
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via Sergio Pansini 5, 80131, Naples, Italy.
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Thyroglossal Duct Lipoma: A Case Report and a Systematic Review of the Literature for Its Management. Diagnostics (Basel) 2023; 13:diagnostics13050932. [PMID: 36900076 PMCID: PMC10001181 DOI: 10.3390/diagnostics13050932] [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: 01/11/2023] [Revised: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Thyroglossal duct (TGD) remnants in the form of cysts or fistulas usually present as midline neck masses and they are removed along with the central body of the hyoid bone (Sistrunk's procedure). For other pathologies associated with the TGD tract, the latter operation might be not necessary. In the present report, a case of a TGD lipoma is presented and a systematic review of the pertinent literature was performed. We present the case of a 57-year-old woman with a pathologically confirmed TGD lipoma who underwent transcervical excision without resecting the hyoid bone. Recurrence was not observed after six months of follow-up. The literature search revealed only one other case of TGD lipoma and controversies are addressed. TGD lipoma is an exceedingly rare entity whose management might avoid hyoid bone excision.
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16
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Fountarlis AL, Koltsidopoulos P, Hajiioannou J, Lachanas V, Kalogritsas N, Solomi E, Skoulakis C. A large thyroglossal duct cyst and its management: a case report. Pan Afr Med J 2023; 44:10. [PMID: 36818036 PMCID: PMC9935655 DOI: 10.11604/pamj.2023.44.10.35448] [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: 05/14/2022] [Accepted: 01/01/2023] [Indexed: 01/06/2023] Open
Abstract
Thyroglossal duct cysts (TGDC) are congenital neck cysts, formed as a result of the failure of the thyroglossal duct to involute during embryogenesis and their mean size is 1.5-2.4 cm. We present a case of a 44-year-old male who presented with a history of a large anterior neck mass measuring 8.7x6x6.4 cm and causing dysphagia and mild dyspnea. After being mistaken for a goiter, a clinical diagnosis of TGDC was made based on history, clinical and radiographic findings. The patient was treated with Sistrunk's procedure. No recurrence was noted on follow-up. Thyroglossal duct cysts are generally well-defined small lesions, but even bigger ones are not linked with severe symptomatology. The larger size at presentation may increase the list of potential diagnoses and lead to diagnostic dilemmas. Every effort should be made to rule out malignancy before surgery. Sistrunk's procedure with dissection of the posterior hyoid space should be the standard of care.
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Affiliation(s)
- Athanasios Luca Fountarlis
- Department of Otorhinolaryngology, University Hospital of Larisa, Larisa, Greece,Corresponding author: Athanasios Luca Fountarlis, Department of Otorhinolaryngology, University Hospital of Larisa, Larisa, Greece.
| | | | - Jiannis Hajiioannou
- Department of Otorhinolaryngology, University Hospital of Larisa, Larisa, Greece
| | - Vasileios Lachanas
- Department of Otorhinolaryngology, University Hospital of Larisa, Larisa, Greece
| | - Nick Kalogritsas
- Department of Otorhinolaryngology, University Hospital of Larisa, Larisa, Greece
| | - Efthymios Solomi
- Department of Otorhinolaryngology, University Hospital of Larisa, Larisa, Greece
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17
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张 海, 窦 训, 樊 明, 赵 兴, 尹 德, 朱 慧. [Hyoid body morphology of thyroglossal duct cyst: a comparative study based on imaging]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2023; 37:59-62. [PMID: 36597370 PMCID: PMC10128342 DOI: 10.13201/j.issn.2096-7993.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Indexed: 01/05/2023]
Abstract
Objective:To provide reference for preoperative diagnosis and treatment of thyroglossal duct cyst by studying the morphological changes of hyoid body. Methods:The CT data(midsagittal image) of congenital thyroglossal duct cyst(TGDC group) diagnosed by pathology and the control group(C group) were collected from January 2016 to October 2021. The differences of hyoid body height(HBH), hyoid body width(HBW), hyoid bone thickness(HBT), HBW/HBH, HBT/HBH between the two groups were compared. HBH, HBW and HBT were analyzed by t-test; The HBW/HBH and HBT/HBH were analyzed by Mann-Whitney U test. Results:Twenty-nine cases were included in the TGDC group and 58 in the C group. The HBH in the TGDC group was(8.93 ±0.22) mm and that in the C group was(8.94±0.12) mm, there was no significant difference between the two groups(P>0.05). The HBW in the TGDC group and the C group were(5.09±0.21) mm and(4.48±0.11) mm, and the HBT were(3.84±0.12) mm and(3.13±0.08) mm, respectively, the difference between the two groups was statistically significant(P<0.05). The average rank sum of HBW/HBH in the TGDC group and the C group was 53.95 and 39.03, respectively, and the average rank sum of HBT/HBH was 59.90 and 36.05, respectively, the difference between the two groups was statistically significant(P<0.05). Conclusion:The morphological changes of hyoid body of thyroglossal duct cyst may be helpful for preoperative diagnosis, and it also suggests that hyoid body resection may reduce the possibility of postoperative recurrence.
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Affiliation(s)
- 海港 张
- 苏州大学附属儿童医院耳鼻咽喉头颈外科(江苏苏州,215003)Department of Otorhinolaryngology Head and Neck Surgery, Soochow University Affiliated Children's Hospital, Suzhou, 215003, China
| | - 训武 窦
- 苏州大学附属儿童医院耳鼻咽喉头颈外科(江苏苏州,215003)Department of Otorhinolaryngology Head and Neck Surgery, Soochow University Affiliated Children's Hospital, Suzhou, 215003, China
| | - 明月 樊
- 苏州大学附属儿童医院耳鼻咽喉头颈外科(江苏苏州,215003)Department of Otorhinolaryngology Head and Neck Surgery, Soochow University Affiliated Children's Hospital, Suzhou, 215003, China
| | - 兴贺 赵
- 苏州大学附属儿童医院耳鼻咽喉头颈外科(江苏苏州,215003)Department of Otorhinolaryngology Head and Neck Surgery, Soochow University Affiliated Children's Hospital, Suzhou, 215003, China
| | - 德佩 尹
- 苏州大学附属儿童医院耳鼻咽喉头颈外科(江苏苏州,215003)Department of Otorhinolaryngology Head and Neck Surgery, Soochow University Affiliated Children's Hospital, Suzhou, 215003, China
| | - 慧娥 朱
- 苏州大学附属儿童医院耳鼻咽喉头颈外科(江苏苏州,215003)Department of Otorhinolaryngology Head and Neck Surgery, Soochow University Affiliated Children's Hospital, Suzhou, 215003, China
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18
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Akaash H, Shahid F, Khan MS. An Unusual Presentation of type-IV Second Branchial Cyst: A Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:6292-6295. [PMID: 36742663 PMCID: PMC9895574 DOI: 10.1007/s12070-021-03034-5] [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: 11/05/2021] [Accepted: 12/07/2021] [Indexed: 02/07/2023] Open
Abstract
Second branchial cleft cysts are a cystic dilatation of the remnant of the second branchial cleft that account for 95-percent of all branchial cleft malformations, along with second branchial fistulae and sinuses. Among them, the type-IV second branchial cyst is present against the pharyngeal wall in the parapharyngeal space and is rarest of all. Herein we report a rare presentation of type-IV second branchial cyst where MRI played a critical role for accurate preoperative diagnosis. The transcervical approach is a safe and effective technique for proper exposure and hence total surgical excision in such cases.
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Affiliation(s)
- Haitham Akaash
- Department of ENT Head and Neck Surgery, Holy Family Hospital, Rawalpindi, Pakistan
| | - Fatima Shahid
- Department of ENT Head and Neck Surgery, Holy Family Hospital, Rawalpindi, Pakistan
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19
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Salem R, Ahmed S, Gupta P, Xiao Y, Morris M, Tiesenga F. Atypical Presentation of Epidermoid Inclusion Cyst in a 60-Year-Old Female: A Case Report. Cureus 2022; 14:e29749. [DOI: 10.7759/cureus.29749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2022] [Indexed: 11/05/2022] Open
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20
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Kim JM, Park KW, Kim DH, Lee DH. Thyroglossal Duct Cyst in the Suprasternal Region. EAR, NOSE & THROAT JOURNAL 2022:1455613221086037. [PMID: 35324319 DOI: 10.1177/01455613221086037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A thyroglossal duct cyst (TGDC) is the most common congenital anterior neck mass. It can develop from residual tissue not degenerated during development and is mainly diagnosed in pediatric patients. However, a TGDC is sometimes diagnosed for the first time in adult patients. A TGDC is mainly caused by repeated infections of the duct and there might be no specific symptoms. A TGDC can occur anywhere from the floor of the mouth to the thyroid but is most often found at the infrahyoid level. Over the past 10 years, there has been no report of a TGDC in the suprasternal region among TGDCs in unusual locations. This paper describes one case of a suprasternal TGDC with a review of the literature on this topic.
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Affiliation(s)
- Jong Min Kim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and 65722Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Keon Woo Park
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and 65722Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Do Hyung Kim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and 65722Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and 65722Chonnam National University Hospital, Gwangju, Republic of Korea
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21
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Walker E, Karthik S, Chengot P, Vaidyanathan S. It's not all about the thyroid! Extrinsic and unusual pathology affecting the thyroid gland: A pictorial review. Clin Imaging 2022; 85:29-42. [DOI: 10.1016/j.clinimag.2022.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 12/11/2022]
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22
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Hou T, Liu Z, Gan Q, Debnam JM, Krishnamurthy S. Clinical and cytopathological features of suspected thyroglossal duct cysts and neoplasms arising from them: A large series from a referral cancer center. Cancer Cytopathol 2021; 130:72-79. [PMID: 34529338 DOI: 10.1002/cncy.22511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Thyroglossal duct cysts (TGDCs) are the most common congenital midline cystic lesions in the neck, and they are often evaluated by fine-needle aspiration. Recognizing the cytomorphologic features of TGDCs and their mimics is important for clinical management. METHODS This study examined the clinical, radiological, and cytopathological features of 86 ultrasonography-guided fine-needle aspiration (US-FNA) specimens from clinically suspected TGDCs or malignancies arising from TGDCs and correlated the findings with surgical follow-up and/or imaging studies. RESULTS According to ultrasound examinations of 66 lesions, 17 (25.8%) were cystic, 8 (12.1%) were cystic with septations, 21 (31.8%) were cystic with solid nodules, and 20 (30.3%) were solid or cystic with internal debris. Cytopathologically, 81 lesions (94%) were categorized as benign, 2 (2%) were categorized as atypical, and 3 (3%) were categorized as malignant. In benign lesions, proteinaceous material (63%), histiocytes (63%), colloid (37%), squamous cells (35%), columnar cells (32%), follicular cells (15%), inflammatory cells (9%), and multinucleated giant cells (9%) were noted. Diagnoses in the benign category included TGDC in 64 patients (75%), TGDC or mimics (colloid nodule/epidermoid cyst) in 14 patients (17%), a colloid nodule in 1 patient, and thyroiditis in 1 patient. Surgical resection, performed in 23 patients, confirmed TGDCs in 12, benign mimics in 7, and carcinoma in 4. CONCLUSIONS Cytopathological features, in conjunction with imaging, allowed a definite diagnosis of TGDC in most patients (75%). The presence of mature squamous cells, thyroid follicular cells, with or without colloid and/or lymphocytes alone allowed a differential diagnosis of TGDC and its mimics in 17%. US-FNA findings could not distinguish primary carcinomas arising from TGDCs from metastatic tumors.
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Affiliation(s)
- Tieying Hou
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zhonghua Liu
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Qiong Gan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - J Matthew Debnam
- Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Savitri Krishnamurthy
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Varghese J, Rohren E, Guofan X. Radioiodine Imaging and Treatment in Thyroid Disorders. Neuroimaging Clin N Am 2021; 31:337-344. [PMID: 34243868 DOI: 10.1016/j.nic.2021.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Thyroid hormones T3 and T4 are crucial for development and differentiation of various cells in the body. They are also essential for regulating metabolism in nearly all tissues. Iodine is an integral element in the synthesis of thyroid hormone and is actively transported into the thyroid by a Na+/I- symporter. The thyroid can take up radioactive iodine just like it would take iodine and hence can be used to evaluate and treat several thyroid diseases. Radioactive iodine is one of the first radioisotopes to be used in medicine.
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Affiliation(s)
- Jeena Varghese
- Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, 1400 Pressler Boulevard, FCT12.5000, Houston, TX 77030, USA.
| | - Eric Rohren
- Department of Radiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Xu Guofan
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030-4009, USA
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24
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Fang N, Angula LN, Cui Y, Wang X. Large thyroglossal duct cyst of the neck mimicking cervical cystic lymphangioma in a neonate: a case report. J Int Med Res 2021; 49:300060521999765. [PMID: 33853437 PMCID: PMC8053768 DOI: 10.1177/0300060521999765] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Thyroglossal duct cyst (TGDC) is a congenital neck malformation, with a rate of approximately 7% in paediatric patients. TGDC is rarely detected in infants aged younger than 1 year. Even though TGDC is histologically benign, it is associated with preterm delivery or sudden infant death due to airway obstruction, with a mortality rate of 30% to 40%. We report a rare case of a neonate who presented with a large left lateral neck mass. At 7 to 8 months of gestation, magnetic resonance imaging of the foetal neck showed that there was a high possibility of a cervical cystic lymphangioma. The patient had normal vital signs and was afebrile. She was immediately transferred to our Ear, Nose, and Throat Department for further diagnosis and treatment. A computed tomography scan confirmed a large cystic mass that was positioned against a thyroglossal duct. Excision of the mass in the left neck was performed under general anaesthesia without resecting part of the hyoid bone. A histopathological examination confirmed the diagnosis of a TGDC. Follow-up at 1 year showed no recurrence.
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Affiliation(s)
- Ning Fang
- Department of Otolaryngology, First Hospital of 12510Jilin University, Changchun, China
| | - Laina Ndapewa Angula
- Department of Otolaryngology, First Hospital of 12510Jilin University, Changchun, China
| | - Yu Cui
- Department of Otolaryngology, First Hospital of 12510Jilin University, Changchun, China
| | - Xin Wang
- Department of Otolaryngology, First Hospital of 12510Jilin University, Changchun, China
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25
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Fiedler LS. Management of a prestyloid parapharyngeal first branchial cleft cyst from puncture to surgical excision and how a routine procedure can turn into an emergency. BMJ Case Rep 2021; 14:14/1/e238727. [PMID: 33436361 PMCID: PMC7805352 DOI: 10.1136/bcr-2020-238727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The anatomy of the parapharyngeal space (PPS) is complex and the differential diagnosis of tumours in this area broad. Although primary tumours of the PPS account for only 0.5% of head and neck neoplasms and are benign lesions in 80% of the cases, the surgical management is crucial and needs specific planning and evaluation of CT and/or MRI scans. In literature, there are several ways to surgically deal with PPS tumours and due to location and differentiation, can reach from transparotid, submandibular transcervical and transoral approaches, extending in a mandibulotomy, further radiotherapy. Parapharyngeal cleft cysts are extremely rare and their management can be complex. We describe the presentation, the diagnosis and further management of a 71-year-old woman with a 6 cm first branchial cleft cyst in the PPS from puncture over emergency tracheostomy to elective excision via a combined transcervical/transparotid and transoral approach. We highlight the importance of the differential diagnosis and the and the correct clinical management of this rare entity.
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Affiliation(s)
- Lukas S Fiedler
- Otorhinolaryngology and Head and Neck Surgery, Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier, Deutschland, Germany
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26
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Jain R, Betancourt RL, Rose AS. Lipoblastomatosis: An unusual midline neck mass in a young child. Int J Pediatr Otorhinolaryngol 2021; 140:110544. [PMID: 33296835 DOI: 10.1016/j.ijporl.2020.110544] [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: 10/15/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
Lipoblastomatosis is an extremely rare condition and is often not recognized prior to final pathologic analysis. In this case, a two-year-old female child presented with a non-tender, submental midline neck mass which had enlarged very slowly over the course of five months. The differential diagnosis included lipoma, lymphatic malformation, and thyroglossal duct cycst and a surgical excision was planned. The child was consented for a possible Sistrunk procedure if necessary. Intraoperatively, the mass was adherent to the hyoid bone and clear mucoid drainage was noted during resection leading the team to further weight the possibility of thyroglossal duct cyst and proceed with a Sistrunk procedure. Ultimately, final pathology revealed the diagnosis of lipoblastomatosis.
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Affiliation(s)
- Rhea Jain
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Renée L Betancourt
- Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, USA.
| | - Austin S Rose
- Department of Otolaryngology-Head & Neck Surgery, University of North Carolina School of Medicine, CB#7070, Chapel Hill, NC, 27599-7070, USA.
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27
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Barbieri A, Prasad ML, Gilani SM. Thyroid tissue outside the thyroid gland: Differential diagnosis and associated diagnostic challenges. Ann Diagn Pathol 2020; 48:151584. [PMID: 32871503 DOI: 10.1016/j.anndiagpath.2020.151584] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022]
Abstract
The presence of thyroid tissue outside of the thyroid gland may occur in various clinical settings and anatomic locations and includes both benign and malignant differential diagnoses. Some of these entities include thyroglossal duct cyst, lingual thyroid, parasitic nodule, thyroid tissue within a lymph node and struma ovarii. In routine daily practice, these entities do pose diagnostic challenges for the pathologists. Differential diagnostic considerations depend largely on the location of lesion and the histologic features. A definitive diagnosis may remain unclear in some cases while knowledge is still evolving in others i.e., incidentally detected bland appearing thyroid follicles in a lateral neck lymph node. This article aims to elaborate on the various entities characterized by thyroid tissue outside of the thyroid gland, both benign and malignant, and the relevant differential diagnostic considerations.
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Affiliation(s)
- Andrea Barbieri
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Manju L Prasad
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Syed M Gilani
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA.
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28
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Tsai MS, Chang GH, Chuang HC, Lin WN, Tsai YT. Thyroglossal duct lipoma: A rare case report. Medicine (Baltimore) 2020; 99:e20392. [PMID: 32481427 DOI: 10.1097/md.0000000000020392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Thyroglossal duct cyst (TGDC), the most common midline neck mass, has several histological diagnoses other than cyst in the literature. We present the first case of thyroglossal duct lipoma. PATIENT CONCERNS A 63-year-old woman presented with a painless soft midline neck mass for more than 3 years, which enlarged in size and caused a lump sensation during swallowing. DIAGNOSES Sonography revealed a 3.5 × 3.0 × 3.0-cm homogenous isoechoic oval lesion without an acoustic shadow beyond the thyroid glands. An ultrasound-guided biopsy revealed abundant sheets of fat cells with infiltration of some lymphocytes and histiocytes. Computed tomography revealed a 3.5 × 3.0 × 3.0-cm well-circumscribed ovoid mass with Hounsfield unit (HU) between -50 and -100 and a thyroglossal duct remnant. All these findings supported the diagnosis of thyroglossal duct lipoma. INTERVENTIONS The patient underwent Sistrunk operation for excision of the neck tumor, and pathological examination revealed an adipose tumor surrounded by benign thyroid tissue, confirming the diagnosis of thyroglossal duct lipoma. OUTCOMES Neither postoperative complication nor recurrence was noted at the 18-month follow-up. LESSONS This is the first case of thyroglossal duct lipoma in the literature. Our study extends the disease spectrum of thyroglossal duct mass and suggests that clinicians should consider thyroglossal duct lipoma in the differential diagnosis of a midline neck mass.
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Affiliation(s)
- Ming-Shao Tsai
- Department of Otolaryngology - Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital
- Health Information and Epidemiology Laboratory of Chiayi Chang Gung Memorial Hospital, Chiayi
- Graduate Institute of Clinical Medical Sciences, Chang Gung University
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan
| | - Geng-He Chang
- Department of Otolaryngology - Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital
- Health Information and Epidemiology Laboratory of Chiayi Chang Gung Memorial Hospital, Chiayi
- Graduate Institute of Clinical Medical Sciences, Chang Gung University
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan
| | - Huei-Chieh Chuang
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan
- Department of Pathology, Chiayi Chang Gung Memorial Hospital, Chiayi
| | - Wan-Ni Lin
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan
- Department of Otolaryngology - Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology - Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital
- Health Information and Epidemiology Laboratory of Chiayi Chang Gung Memorial Hospital, Chiayi
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29
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Thyroglossal duct cysts and site-specific differential diagnoses: imaging findings with emphasis on ultrasound assessment. J Ultrasound 2020; 23:139-149. [PMID: 32052384 DOI: 10.1007/s40477-020-00433-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 01/29/2020] [Indexed: 02/07/2023] Open
Abstract
Thyroglossal duct cysts (TGDCs) are the most common congenital abnormality of the neck, accounting for approximately 70% of congenital neck lesions. Two-thirds of thyroglossal duct anomalies are diagnosed within the first three decades of life, with more than half being identified before 10 years of age. The age of presentation, clinical examination and imaging are essential for an accurate diagnosis. This review aims to summarize the imaging findings of TGDCs and their main differential diagnoses with emphasis on ultrasound assessment. A focus on site-specific key differentiating between them is also addressed.
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30
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Abdel Razek AAK, Sherif FM. Differentiation of sublingual thyroglossal duct cyst from midline dermoid cyst with diffusion weighted imaging. Int J Pediatr Otorhinolaryngol 2019; 126:109623. [PMID: 31400658 DOI: 10.1016/j.ijporl.2019.109623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 01/31/2023]
Abstract
PURPOSE to differentiate sublingual thyroglossal duct cyst (TGDC) from midline dermoid cyst (DC) with diffusion weighted imaging (DWI). MATERIALS AND METHODS Retrospective analysis of 22 consecutive patients (11 male and 11 female aged 5-15 years) with midline cystic lesion at floor of mouth. They underwent DWI of floor of mouth. Apparent diffusion coefficient (ADC) of the cystic lesions was calculated and correlated with surgical findings. RESULTS The mean ADC value of TGDC of 1st observer was (2.20 ± 0.28 × 10-3 mm2/s) and of 2nd observer was (2.28 ± 0.27 × 10-3 mm2/s) was significantly higher than that of DC (P = 0.001) whose ADC of 1st observer was (1.55 ± 0.15 × 10-3 mm2/s) and of 2nd observer was (1.53 ± 0.11 × 10-3 mm2/s). There was excellent inter-observer agreement of both readings (r = 92%, P = 0.001). When ADC of 1.76 and 1.62 × 10-3 mm2/s was used as a threshold value for differentiating TGDC from DC, the best results were obtained with area under the curve of 0.94 and 0.96, accuracy of 90% and 86%, sensitivity of 91% and 91%%, specificity of 90% and 80%, negative predictive value of 90% and 88% and positive predictive value of 92% and 84% of both reviewers respectively. CONCLUSION DWI is reliable and reproducible imaging modality for differentiation sublingual TGDC from DC.
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Affiliation(s)
| | - Fatma Mohamed Sherif
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
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