Thyroglossal duct diseases: presentation and outcomes

Abstract

Objective The incidence of thyroglossal duct diseases in the general population is about 7%. We aimed to demonstrate the clinical presentations and management of thyroglossal duct diseases. Methods We conducted a retrospective review of all patients who underwent surgery for histopathologically confirmed thyroglossal duct cyst, sinus, or fistula at a single center. Results A total of 151 cases were included in this study. There were more female patients (87, 58%) than male patients (64, 42%). The patients’ ages ranged from 1 to 63 years old. The most prevalent complaint was painless upper midline neck swelling (93.3%). Most cases were diagnosed as thyroglossal duct cysts (137, 90.7%). Six cases (4%) were associated with carcinoma. All the cases were managed using the modified Sistrunk procedure. There were no procedure-related complications, and five cases of recurrence. Conclusions Although thyroglossal duct cyst is the most common neck anomaly in children, it may also present with various characteristics later in life. This condition can be managed successfully without complications and with a low recurrence rate.

Carcinoma arising from thyroglossal duct remnants

“…TGDC is one of the most common congenital anomalies, with a wide range of differential diagnoses, that is rarely associated with carcinoma ( 1 , 8 , 9 ). Although it is uncertain how cancer arises at this location, it is thought to be the result of the neoplastic transformation of normal residual thyroid tissue throughout the thyroglossal cystic tube.…”

“…Thyroglossal duct cysts (TGDCs) are unusual remnants of the thyroid gland that can arise anywhere along the thyroid migration pathway ( 1 ). This phenomenon is the most prevalent type of congenital neck mass in children, with a frequency of ~7% in the general population ( 1 ).…”

“…Thyroglossal duct cysts (TGDCs) are unusual remnants of the thyroid gland that can arise anywhere along the thyroid migration pathway ( 1 ). This phenomenon is the most prevalent type of congenital neck mass in children, with a frequency of ~7% in the general population ( 1 ). During embryonic development, in the first six weeks of pregnancy, the thyroid gland begins to descend toward its definitive anatomical position, and afterward, the thyroglossal duct normally undergoes complete atrophy by the tenth week ( 1 ).…”

“…This phenomenon is the most prevalent type of congenital neck mass in children, with a frequency of ~7% in the general population ( 1 ). During embryonic development, in the first six weeks of pregnancy, the thyroid gland begins to descend toward its definitive anatomical position, and afterward, the thyroglossal duct normally undergoes complete atrophy by the tenth week ( 1 ). However, failure to undergo atrophy can lead to the formation of TGDC, which can be in the form of a cyst, fistula, duct, tract or ectopic thyroid tissue ( 2 ).…”

“…The area beneath the hyoid bone emerges as the predominant site of origin for the anomaly. Complications associated with this congenital anomaly may include severe infection, localized inflammation, pain, swelling, malignancy and the development of fistulas ( 1 ). According to the literature, cancer rarely develops from TGDCs.…”