A Giant Lateral Thyroglossal Duct Cyst in A 85-Year-Old Man: Case Report
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Hyoid bone
Thyroglossal cyst
Neck mass
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Abstract The thyroglossal duct cyst is the neck congenital abnormality most common in the childhood. Clinically, it shows itself as a solitary neck mass in the region of hyoid bone, it is painless and can be dislocated during de physical examination and tongue protrusion. The most common treatment is its removal through the Sistrunk technique. Patient with diagnosis of thyroglossal duct cyst in neck region with extension to the mouth floor was treated by total surgical removal through intraoral access. The intraoral approach to the treatment of the thyroglossal duct cyst showed itself practicable and permitted the total removal of the lesion with no recurrence signs.
Hyoid bone
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Neck mass
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Thyroglossal duct remnants presenting as a lump in the neck are usually called thyroglossal cysts. Meticulous dissection of the cyst and duct, along with the body of the hyoid bone (Sistrunk's operation) is necessary to avoid recurrence. The authors have reviewed the histology of 61 consecutive specimens diagnosed preoperatively as thyroglossal cysts and have found that a true cyst exists in only 46 per cent of cases.
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Hyoid bone
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Neck mass
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Objective To explore the postoperative recurrence factors and the prevention of thyroglossal duct cyst(TGDC).Method Clinical data and surgical effects of 26 patients with TGDC was analyzed retrospectively.Results All surgical specimens were confirmed by pathology.Recurrence rate was 11.5%(3/26) during the 1-year follow-up.The reasons of recurrences were thyroglossal tract remnant(TTR) for 2 cases owing to remaining the middle of hyoid bone and caecus upper hyoid bone,and thyroglossal branch remnant(TBR) for 1 case.Conclusions To reduce recurrence,it is essential of the full knowledge of the anatomy characteristics of TGDC,clear diagnosis before operation,appropriate timing of surgery,gently operation and thorough removal of the thyroglossal tract and its branches.
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Neck mass
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A clinical case of ectopic thyroid carcinoma in front of hyoid bone was reported in this paper. The patient, a 17-year-old female, presented with an enlarging neck mass of 1-week history. Physical examination revealed a 3 cm×2 cm neck mass in front of the hyoid bone. Ultrasonographic depicted as a cystic solid mixed echogenic mass with punctate strong echogenicity. CT scan showed a cystic-solid mass in front of the hyoid bone with punctate calcifications. The patient was misdiagnosed as a thyroglossal duct cyst and underwent surgery. The final pathological diagnosis was papillary thyroid carcinoma with cyst formation.摘要：报道1例17岁女性舌骨前异位甲状腺癌患者，因发现颈前肿物1周余入院。体检见颈前舌骨平面一3 cm×2 cm大小肿物。彩超探及一囊实性混合回声团块，内见点状强回声。CT提示舌骨前囊实性病灶，内见点状致密钙化影。误诊为甲状舌管囊肿，行手术治疗，术后病理诊断为甲状腺乳头状癌伴囊肿形成。.
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CONGENITAL lesions make up about 6% of all masses found within the neck.1Approximately two thirds of these congenital abnormalities involve the thyroglossal duct in the form of cysts or sinuses. Despite the frequent occurrence of thyroglossal duct malformations, a familial pattern, to our knowledge, has not been described.
Report of a Case
A healthy 1-year-old girl was admitted to the Denver General Hospital with a painless, midline cervical mass over the hyoid bone. There was no history of airway or feeding problems and no symptoms of any endocrine disorder. The family history was remarkable for hypothyroidism, thyroid carcinoma, and thyroglossal duct defects (Figure). Physical examination disclosed a 1×1-cm, nontender cervical mass located in the midline at the level of the hyoid bone. No cutaneous fistulous tract was noted. These findings were suggestive of a thyroglossal duct cyst. Surgical excision, using the Sistrunk technique,2demonstrated a squamous cell-linedHyoid bone
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Introduction A thyroglossal duct cyst (TGDC) is the most frequent embryonic-origin cervical mass situated in the anterior of the neck. This anomaly occurs in approximately in 7% of people, usually in children. Mainly it presents as a mobile, non-tender, usually inferior to the hyoid bone (~75% of patients) painless swelling but it can be painful when accompanied by local inflammation. The recommended management for TGDC is the Sistrunk procedure, ensuring removal of the full length of the duct remnants by including the midportion of the hyoid bone. Case series presentation The aim of this paper is to present a case series of five patients who were operated in the OMFS department of Papanikolaou Hospital of Thessaloniki within 2.5 years (9/2019-2/2022). The patients were four males (80%) (mean age 50.5 years, outliers 36 and 71years) and one (20%) 63 years old female. All of them presented with a mobile painless neck swelling and they had normal thyroid function. All patients underwent a surgical excision of thyroglossal cyst including the midportion of hyoid bone (Sistrunk procedure). None of them presented a recurrence. Conclusion A TGDC, although it is rare in adults as it is typically diagnosed and treated surgically in childhood, it can be complicated with inflammation. In any case, surgical resection and histological confirmation are required as cases of malignant lesion have been reported.
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Thyroglossal duct cyst is the most common congenital neck mass. About 50% of cases present before the age of 10. A second group present in young adulthood.We present a case of an 85 years old male patient who presented to us with a huge swelling occupying the whole front of the neck, matching the characters of a thyroglossal cyst by history and clinical examination. The swelling first appeared in early adulthood. He received faulty advice that led him to believe that the operation was too risky. He lived without treatment or complications except for very slow progressive enlargement of the swelling over the years until it became cosmetically very bad and interfering with his daily activities. The swelling was cystic, non-tender with surrounding healthy skin except small area showing minimal signs of inflammation. Neck US and (CT) confirmed the diagnosis of thyroglossal cyst, 92*76 mm in size.We performed surgical excision of the cyst, tract and central part of hyoid bone (Sistrunk operation) and sent the specimen for histopathological evaluation, which confirmed pre-operative diagnosis.Diagnosis of TGDC shouldn't be excluded even in extremes of age, or extreme size, and can be managed according to standard lines of management.
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