Surgical Removal of Rheumatoid Nodule That Presented as a Thyroglossal Duct Cyst: A Case Report

Rheumatoid nodules are extraarticular complications in rheumatoid arthritis (RA). This report details how a 63-year-old female patient with a history of lung and kidney cancer presented to the otolaryngology clinic with left submandibular region neck pain and a lesion that looked like a thyroglossal duct cyst on imaging. The patient also had accompanying joint pain. After the patient underwent a full workup including positron emission tomography and computed tomography scans, she underwent surgery to remove the suspected thyroglossal duct cyst via a Sistrunk procedure. Pathology indicated that it was a rheumatoid nodule. The patient was never diagnosed with RA until after removal of the nodule was done. The patient ended up being evaluated by rheumatology and has subsequently been treated for RA. This rare case highlights the importance of interdepartmental communication and assessment of all patient symptoms on examination.

Treatment of relapses of benign latero-cervical pathology: a narrative literature review

Benign laterocervical pathologies are not without pitfalls. Many may relapse after many years and, sometimes, they cannot be predicted. The purpose of this review is to describe the surgical measures necessary for the treatment of relapses of the most common benign laterocervical masses. We searched PubMed, Embase and Cochrane Central Register of Controlled Trials databases for articles describing the treatment of the most common benign cervical disease recurrences, and summarised available evidence in this narrative review. We overviewed observations about recurrent benign mixed tumour (pleomorphic adenoma), parapharyngeal space tumours and carotid body paragangliomas, thyroglossal duct anomalies and branchial cleft anomalies. Proper surgical technique is crucial for safely and effectively managing the relapses of benign latero-cervical diseases. Radiotherapy is indicated in several cases of recurrence such as pleomorphic adenoma and unresectable paraganglioma. Long-term follow-up is of utmost importance to promptly recognise and treat recurrencies.

A rare location of papillary carcinoma: Thyroglossal duct cyst

The inadequate closure of the thyroglossal tract paves the way for a thyroglossal cyst. Thyroglossal duct cyst (TDC) malignancy is quite rare. A thirty-nineyear-old female patient was admitted to the polyclinic with a complaint of palpable mass in the neck. Findings compatible with TDC were determined in the patient's neck screening and it was considered to be malignant due to irregular margins, apparent vascularization and punctual calcifications. Fine needle aspiration biopsy was unremarkable. TDC was excised by Sistrunk procedure and frozen examination was performed. Total thyroidectomy was performed additionally since the result of the frozen examination was found to be compatible with the primary papillary carcinoma of TDC. If preoperative biopsy does not provide a diagnosis, frozen section study will be beneficial in terms of both providing the early diagnosis and directing the operation strategy during the surgery in clinically or radiologically suspected patients.

Thyroglossal Duct Lipoma: A Case Report and a Systematic Review of the Literature for Its Management

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.

Papillary Carcinoma Within Thyroglossal Duct Cyst: A Rare Midline Coexistence

Thyroglossal duct cysts (TDCs) develop papillary carcinomas in very rare cases. Mostly, in such cases, the diagnosis is established after the excision of a clinically benign TDC. An anterior neck mass was found in a 43-year-old man with papillary carcinoma arising in a TDC. Clinical, radiological, and analytical controls are necessary for the management of papillary carcinoma in the TDC. There is no need for thyroidectomy unless there are palpable abnormalities in the gland or significant changes on an ultrasound. The outcome of the papillary carcinoma does not seem to be significantly impacted by routinely performed thyroidectomy.

Dual Ectopic Thyroid: A Case Report

Background

Ectopic thyroid gland is an uncommon disorder in which thyroid tissue is located along the line of migration, dual ectopic thyroid is a rare entity where parts of the gland are located in two different locations.

Case

A 14-year-old girl presented with dysphagia and odynophagia of six years duration with worsening of two weeks. Physical exam showed tongue base mass. Imaging revealed two enhancing masses at the tongue base and inferior to the hyoid bone. A diagnosis of dual ectopic thyroid was made.

Conclusion

Dual ectopic thyroid is a rare occurrence and proper diagnosis is essential for proper management.

Actinomycotic Abscess of Thyroid Gland in a 3-Year-Old Child

Actinomycosis is an atypical cause of infection in the head and neck area, especially in children. A rare incidence of actinomycosis, its nonspecific clinical signs that mimic other pathological conditions, as well as a complicated identification of microorganism lead to diagnostic delays in clinical practice. Besides an accurate diagnosis, it is of an utmost importance to pinpoint relevant predisposing factors, which might result in the infection. We present a clinical case of actinomycotic infection of the thyroid gland in the pediatric patient at our department.

Isolated poorly differentiated cancer (insular) in a thyroglossal cyst: a case report

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

Two-year old girl with glial choristoma presented in a thyroglossal duct cyst

BACKGROUND

Neuroglial choristomas are rare entities that are composed of differentiated neuroectodermal cells presenting where they do not belong.

CASE

Here in this paper, we represent a two-year old patient with a very rare presentation of neuroglial choristoma which manifested itself within a thyroglossal duct cyst. In this paper we will also discuss pathogenesis, clinical manifestation, differential diagnosis and management of the neuroglial choristomas.

CONCLUSION

In conclusion we believe this unique case may aid in understanding the pathophysiology, differential diagnosis, and management of this rare congenital anomaly.

Management of Thyroglossal Cyst in Adults: A Single-Institution Experience

Objectives:

Thyroglossal duct cyst (TDC) is the most common congenital anterior neck mass in clinical practice. Due to its congenital origin, presentation in adulthood is uncommon with only 7% of cases presenting in this age group. Data are therefore limited on the management of TDC in adults, particularly in Sub-Saharan Africa. This study describes the pattern of the presentation and treatment outcomes, following the management of TDC in a series of adults in a Nigerian tertiary hospital.

Subjects and Methods:

A retrospective review of all adult patients with TDCs over a 5-year period was carried out. Sociodemographic data, operative details, and postoperative outcomes were obtained and presented as descriptive statistics.

Results:

Seven adult patients, including five males and two females, were managed during the period. Their ages ranged from 19 to 60 years, with a mean of 37 ± 16.4 years. All the patients presented with anterior neck swellings which had been present for a median duration of 3 years. Cysts were located in the infrahyoid position in all instances, and all had Sistrunk operation over a mean operative time of 78 ± 16 min. There were no intraoperative complications. The mean duration of the postoperative stay was 2 days. There was no recurrence after a median follow-up period of 15 months.

Conclusion:

This study highlights the rarity of TDC in adults and describes a single institution's experience with the management of adult cases of TDC using the classical Sistrunk operation.

Risks and complications of thyroglossal duct cyst removal

OBJECTIVES/HYPOTHESIS

Thyroglossal duct cysts (TGDCs) are the most common congenital neck cyst and typically present in childhood or adolescence, although a subset remains asymptomatic until adulthood. Although treatment involves surgical excision, few large-scale studies exist regarding the risks of surgical treatment of TGDCs in adults. This study aims to describe the characteristics of adult patients undergoing TGDC excision and to analyze risk factors associated with reoperation or other postoperative complications.

STUDY DESIGN

Retrospective cohort study utilizing the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database.

METHODS

Patients age ≥ 18 years in the NSQIP database who underwent TGDC removal from 2005 to 2014 were included. Covariates included patient demographics, comorbidities, preoperative variables, and intraoperative variables. Outcomes included reoperation, complications, and length of hospital stay.

RESULTS

A total of 793 cases met inclusion criteria. Patients were predominantly female (57.0%) and white (64.3%), with a mean age of 44.3 years. Thirty-day mortality did not occur in this cohort, but 3.0% of patients experienced at least one complication. Forty-eight patients (6.1%) underwent reoperation. Wound infection rates were higher in revision operations compared with primary operations (8.3% and 0.9%, respectively; P = .003). Low preoperative sodium was associated with reoperation (P = .047). Additionally, length of hospital stay was associated with increased total operative time (P = .02).

CONCLUSIONS

TGDC excision is a safe and well-tolerated procedure in the adult population, with low complication rates. However, the risk of reoperation, surgical-site infections, and medical complications should be taken into consideration during preoperative planning.

LEVEL OF EVIDENCE

NA Laryngoscope, 130:381-384, 2020.

[Cancer of the thyroglossal duct]

The authors present the clinical observation of the cancer of the tongue-lingual duct together with the concise overview of the relevant literature and the discussion of etiology and pathogenesis of this condition.

An Incidental Primary Papillary Carcinoma Arising in a Thyroglossal Duct Cyst: Report of a Rare Finding

The thyroglossal duct cysts (TGDCs) are the most common congenital anomaly of the thyroid, usually manifested as painless midline neck mass. Malignancy is very rare and is reported in around 1% of cases as an incidental finding after histopathological evaluation of resected cyst. Papillary carcinoma is the most common carcinoma reported in TGDC. Here, we report a case of 17-year-old-female, who presented with a gradually increasing midline neck mass which moves with swallowing. On imaging a diagnosis of infected TGDC was made. The Sistrunk operation was done and a diagnosis of primary papillary carcinoma arising in a TGDC was rendered histopathologically. The contemporary appearance of papillary carcinoma thyroid was reported in about 20% cases of TGDC carcinoma, thus it is essential to differentiate primary papillary carcinoma arising in a TGDC from those of metastatic papillary carcinoma thyroid by strict diagnostic criteria.

A rare case of triple thyroid ectopia

Various anomalies of thyro-glossal duct have been described, in which the duct may form a cyst or may present as a solid nodule to form an ectopic gland. The ectopic gland can develop along the tract of the duct to give rise to ectopic lingual, sublingual (pre-hyoid) or sub-hyoid (pyramidal) gland, with or without normal pre-tracheal thyroid gland.There are a few reports of double ectopia of thyroid but triple ectopia of thyroid is extremely rare. We have come across a case of triple thyroid ectopia, i.e., thyroid tissue at three locations along the tract of descent of thyro-glossal duct on CT, which hast been rarely reported in the world literature, and hence this report.

Ectopic thyroid carcinoma. Case report

INTRODUCTION

Ectopic thyroid tissue can be found in many sites, including the tongue, thyroglossal duct, mediastinum, trachea, lung, aorta and abdomen. Ectopic thyroid tissue may also be involved in the same processes as normal, orthotopic thyroid gland. These processes include tumors, inflammation and hyperplasia. The appearance of such tissue in rare locations may lead to diagnostic and therapeutic dilemmas.

CASE REPORT

We report a rare case of ectopic thyroglossal thyroid carcinoma in a 63-year-old Caucasian male with a normal orthotopic thyroid gland.

CONCLUSION

Although 99% of thyroid cancers develop within the thyroid itself, in rare cases a carcinoma can arise in ectopic thyroid tissue located in the neck or in other areas of the body. Though rare, the possibility of an ectopic thyroid carcinoma must always be considered by the surgeon in cases of a pathological mass in the neck.