A rare case of a concurrent large thyroglossal duct cyst with a base of tongue haemangioma

Abstract

An 85-year-old lady presented with a large midline neck mass. After 8 years of steady growth, the previously asymptomatic mass began to cause stridor and dysphagia. The patient's comorbidities included a previous partial glossectomy for haemangioma of the tongue, chronic obstructive pulmonary disease, congestive cardiac failure and obesity (body mass index >30). CT neck revealed the midline mass was cystic in nature, most likely a thyroglossal duct cyst. This mass was closely related to an angiomatous malformation involving the tongue, floor of mouth and left parotid. Fine needle aspiration cytology was consistent with a colloid goitre characterised as Thy-1. Due to her extensive comorbidities, surgical resection of the midline mass was deemed to be a high-risk procedure. A Sistrunk's procedure was performed. Dissection proved difficult due to the intimately related base of tongue haemangioma. Histopathology confirmed it to be a benign thyroglossal duct cyst. She made an uncomplicated postoperative recovery.

Incidence and outcome of thyroglossal duct cyst

“…17 About anatomical location infrahyoid is the most presentation of our study which is supported by almost all other series. 18,19 Anterior midline location is most of our patient if presentation is laterally left side is more (80%) which is supported by Scott-Brown's Otorhinolaryngology Head and Neck Surgery, Eight Edition. 20 The presenting symptom and sign were variable in different studies, they may be present with infected abscess formation, fistula or discharging sinus or painless cystic swelling.…”

Large Thyroglossal Duct Cyst: A Case Report

“…Another case was reported by Baisakhiya, the patient was a 65-year-old male with a huge, multilobular thyroglossal duct cyst, measuring 11×9 cm on physical examination [9]. McNamara described a case of an 85-year-old female patient who had a recurrent tongue hemangioma associated with a giant thyroglossal duct cyst, that measured 10×8 cm on examination and 11×4×3 cm upon removal and examining the gross specimen [10]. Ramalingam reported a case of an adult with a cystic neck mass measuring 8×7 cm on physical examination [11].…”

A cavernous hemangioma of the tongue base presenting as an ectopic thyroid: A case report

“…Even though they are fairly common in the head and neck region, their occurrence in the pharynx, especially in the tongue base, is extremely rare [ 9 , 12 , 14 , 15 ].…”

“…Recurrence of hemangiomas after treatment has been reported in literature [ [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] ], regardless of the initial treatment used. Therefore, patients should benefit from a regular and meticulous follow-up after treatment.…”

“…Although hemangioma is one of the most common soft tissue tumors of the head and neck region, it remains relatively rare in the oral cavity, and is particularly rare in the tongue base [ 9 , 10 ].…”