Histological Characterization of the Thyroglossal Tract: Implications for Surgical Management

Chandra, Rakesh K.; Maddalozzo, John; Kovarik, Paula

doi:10.1097/00005537-200106000-00014

Cited by 54 publications

(39 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although multiple studies have addressed the clinical features of TGDC, few have included a detailed analysis of the associated pathologic findings [8,[13][14][15][16][17][18][19][20]. To date, there has been no large community practice based series evaluating TGDC histologically compared with management outcomes.…”

Section: Introductionmentioning

confidence: 99%

A Clinicopathologic Series of 685 Thyroglossal Duct Remnant Cysts

Thompson¹,

Herrera²,

Lau³

2016

Head and Neck Pathol

109

104

View full text Add to dashboard Cite

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 %).

show abstract

Section: Introductionmentioning

confidence: 99%

A Clinicopathologic Series of 685 Thyroglossal Duct Remnant Cysts

Thompson¹,

Herrera²,

Lau³

2016

Head and Neck Pathol

109

104

View full text Add to dashboard Cite

show abstract

“…Otherwise, it was considered a VC, being the most common cyst in the valleculae. Pathologically, both lesions are lined by a similar epithelium, and thus, relying on the presence of thyroid tissue is important to differentiate between them as this is present in 46% of the TGDCs [13].…”

Section: Discussionmentioning

confidence: 99%

A Vallecular Thyroglossal Duct Cyst Presenting with Persistent Unexplained Cough in a Toddler

2014

Int J Otorhinolaryngol

View full text Add to dashboard Cite

“…We therefore propose that if an incidental TGDC is discovered during surgery, it should be managed in the same manner as a symptomatic TGDC and excised in continuity with the middle third of the hyoid [10][11][12][13][14][15] An exception would be if a Sistrunk procedure would compromise the outcome of the planned surgery. In our small series, a Sistrunk procedure did not negatively impact the outcome of laryngotracheal reconstruction, with all four children being successfully decannulated.…”

Section: Discussionmentioning

confidence: 99%