Update on endoscopic management of lingual thyroglossal duct cysts

Burkart, Collin M.; Richter, Gresham T.; Rutter, Michael J.; Myer, Charles M.

doi:10.1002/lary.20534

Cited by 56 publications

(43 citation statements)

References 19 publications

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“…The overall distribution of TGDC in the present study was similar to that documented by others, with approximately three quarters of cysts positioned in an infrahyoid location [3, 8-11, 13, 15, 22, 24]. TGDC can rarely occur in the tongue, mediastinum, or larynx [3,4,26]. Although not emphasized in prior large series, TGDC may also arise within the substance of the thyroid gland, as evidenced by the eleven cases of intrathyroidal TGDC observed in the current study.…”

Section: Discussionsupporting

confidence: 89%

A Clinicopathologic Series of 685 Thyroglossal Duct Remnant Cysts

Thompson¹,

Herrera²,

Lau³

2016

Head and Neck Pathol

108

104

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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: Discussionsupporting

confidence: 89%

A Clinicopathologic Series of 685 Thyroglossal Duct Remnant Cysts

Thompson¹,

Herrera²,

Lau³

2016

Head and Neck Pathol

108

104

View full text Add to dashboard Cite

show abstract

“…Work up may include computed tomography scan, magnetic resonance imaging, lateral neck x-ray, and barium esaphogram. Thyroid nuclear imaging and thyroid function test can help rule out ectopic thyroid tissue [2,3,9].…”

Section: Discussionmentioning

confidence: 99%

“…The TGDC, on the other hand, is a common cause of a congenital neck mass in the pediatric age group [9]. Thyroglossal duct cysts can arise anywhere from foramen cecum in the tongue to the suprasternal region [10,11].…”

Section: Discussionmentioning

confidence: 99%

“…Embryologically, the thyroid gland develops as an epithelial proliferation on the midline at the anterior floor of pharynx and then migrates from the foramen cecum inferiorly to its final position anterior to the upper portion of the trachea in the 7th week of gestation. The duct eventually involutes, but the epithelial remnants could be left behind anywhere along the migratory pathway and aberrant pathway may result in a TGDC being developed at unusual sites [9,10,11]. It is primarily managed by surgical excision [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…The duct eventually involutes, but the epithelial remnants could be left behind anywhere along the migratory pathway and aberrant pathway may result in a TGDC being developed at unusual sites [9,10,11]. It is primarily managed by surgical excision [9,10].…”

Section: Discussionmentioning

confidence: 99%

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