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PubMedDate not supplied

Thymopharyngeal duct cyst: a form of cervical thymus.

The various types of cervical thymus may present as a neck mass, usually laterally, from the angle of the mandible to the manubrium. Since it is rare to diagnose the entity preoperatively, the differential diagnosis includes the more common branchial cleft cyst, thyroglossal duct cyst, cystic hygroma, cystic dermoid, and lesions of the salivary gland, thyroid, parathyroid, and cervical lymph nodes. Because cervical thymic tissue in various forms has been reported so frequently, we feel the entity should be considered in the clinical differential diagnosis of lateral neck mass, especially in the younger age group.

Branchioma↗
PubMedDate not supplied

Cutaneous bronchogenic cyst of the back: a case report and review of the literature.

Cutaneous and subcutaneous cysts with ciliated pseudostratified columnar (respiratory) epithelium present a diagnostic dilemma. We report a case of a bronchogenic cyst occurring on the back. The differential diagnosis includes branchial cleft cyst, thyroglossal duct cyst, cutaneous ciliated cyst, and mature cystic teratoma. We review reports of extrapulmonary bronchogenic cysts and discuss their possible embryology.

Back↗
PubMed2005

[An unusual lingual cyst lined by respiratory epithelium].

Apart from several well-established types of developmental cysts in the tongue such as dermoid cyst, lymphoepithelial cyst, and thyroglossal cyst, there are two rare lingual cysts known as lingual cyst of foregut origin and lingual alimentary cyst. In this report, a lingual cyst with a wide involvement of the tongue is presented in a nine-year-old boy with findings of ultrasonography, computed tomography, and magnetic resonance imaging. Postoperative histopathologic examination showed a lingual cyst of foregut origin lined by respiratory epithelium.

Cysts↗
PubMed2002

[A thyroglossal duct cyst with ectopic thyroid carcinoma].

An asymptomatic swelling in the neck of a 15-year-old boy, was revealed after resection to be due to a papillary thyroid carcinoma. He was treated with a near-total thyroidectomy, radiotherapy at an ablation dosage due to a scintigraphically demonstrated remnant thyroid tissue, and thyroid hormone supplement. Almost 2 years after the tumour resection, a recurrent carcinoma was found in the neck. Prior to the resection of symptomatic thyroglossal duct cysts, it should be ascertained whether nodular thyroid abnormalities are present. In about 1% of resected thyroglossal duct cysts a carcinoma is found, most often of the papillary type. In 10-40% of the patients who undergo a subsequent thyroidectomy, malignant focuses are also found in the thyroid. In view of this multifocal occurrence and the fact that in most cases the diagnosis of carcinoma is only made after the operation, which often implies uncertainty about oncological radicalness, the authors advice to perform a (near-)total thyroidectomy as the standard procedure in case of thyroglossal duct carcinoma. After this adequate treatment with 131I should be given. A more limited approach seems only warranted when radicalness is certain and indications for nodular thyroid disease are absent.

Adolescent↗
PubMed2006

Recurrent thyroglossal duct cysts: a 23-year experience and a new method for management.

OBJECTIVES: We present an experience in the management of primary and recurrent thyroglossal duct cysts (TGDCs) and describe a novel method for recurrent TGDC removal. METHODS: We performed a retrospective review of TGDC surgery at Children's Hospital in Seattle from 1980 to 2003. The surgical techniques for primary and recurrent TGDCs and the factors associated with TGDC recurrence were evaluated and analyzed. RESULTS: During the study period, 231 patients underwent 296 TGDC surgeries. Thirty-four of the 231 patients (15%) underwent a total of 88 procedures for recurrent TGDCs. Successful procedures used for secondary TGDC management included central neck dissection with directed base of tongue (BOT) excision in 6 of 9 patients (67%), secondary Sistrunk operation with limited BOT resection in 12 of 27 patients (44%), revision Sistrunk operation with BOT dissection in 7 of 11 patients (64%), and suture-guided transhyoid pharyngotomy in 8 of 8 patients (100%). Ten of the 231 patients (4%) had initial TGDC incision and drainage and then underwent a total of 21 procedures, excluding the incision and drainage. The factors associated with TGDC recurrence were inaccurate initial diagnosis (17 of 34 or 50%), infection (5 of 34 or 15%), unusual TGDC presentation (5 of 34 or 15%), and lack of BOT musculature removal (7 of 34 or 20%). The level of surgeon training affected the surgical outcome. CONCLUSIONS: Successful TGDC treatment requires consideration of factors associated with recurrence. Recurrent TGDCs can be treated by several methods, including suture-guided transhyoid pharyngotomy.

Adolescent↗
PubMed2006

Sudden infant death: lingual thyroglossal duct cyst versus environmental factors.

An 8-month-old female baby was found collapsed in the prone position 30 min after being positioned under soft-bedding. She was taken to the emergency room with cardiopulmonary arrest. Her heartbeat was recovered after resuscitation and continued for 20 h under artificial respiration, at which point the child died. At autopsy, the child showed no significant pathological abnormalities apart from a thyroglossal duct cyst of 2.0 cm diameter, therefore, it seemed that the cyst, which was close to the epiglottis, had caused asphyxia through airways occlusion. However, the child had shown no respiratory problems before death, and the risk of airway occlusion as a result of lingual cysts is more likely in a supine rather than a prone position. A small amount of evidence suggested that the child died as a result of suffocation from being covered by soft-bedding, which could have caused fatal asphyxia; it is also possible that a hypoxic state induced by airway obstruction might have been enhanced by being covered with bedding. It seemed reasonable to assume that death was caused by a combination of the lingual thyroglossal duct cysts and asphyxia caused by being covered in bedding, though the main factor appeared to be the large cyst.

Airway Obstruction↗
PubMed2004

Day surgery for thyroglossal duct cyst excision: a safe alternative.

The goal of this study was to assess which factors affect length of stay in patients operated on for a thyroglossal duct cyst (TDC) and whether day surgery is a safe alternative to a postoperative admission. All charts of patients with TDC excisions at one children's hospital from 1995 to 2001 were reviewed retrospectively. Chi-square tests and multiple logistic regression were used as statistical tests, with p<0.05 considered significant. One hundred children with a mean age of 6 years were operated on for TDC; 46% had day-surgery, with a median length of stay (LOS) of 4 h, and the other 54% were admitted overnight after TDC excision, with a median LOS of 24 h. Factors that significantly prolonged LOS were drain placement, start of surgery after 1 p.m., and surgery being performed by the ENT surgical service rather than the pediatric general surgery service. There was only one hospital readmission for a patient with day surgery at 36 h postoperation for wound hematoma that resolved with nonoperative treatment. Day surgery is safe for routine TDC excisions. There must be a shift in surgeons' behavior if the trend towards an increase in outpatient services for TDC excisions is to continue.

Ambulatory Surgical Procedures↗
PubMed2002

Papillary carcinoma arising in a thyroglossal duct cyst.

A 21-year-old lady was admitted with a one year history of painless swelling in the neck. The clinical features and radiological findings suggested a thyroglossal duct cyst. Histology of the excised duct cyst showed papillary carcinoma. Ultrasound examination of the thyroid gland was normal. The patient is on regular follow-up and is well two years following surgery.

Adult↗
PubMed1999

[Papillary carcinoma of the thyroid in a thyroglossal duct cyst with metastasis to an ipsilateral cervical lymph node].

A 22-year-old male presented with a submandibular cystic mass in the ENT Clinic of Berlin-Buch. Histopathology revealed a dystopic papillary carcinoma in a thyroglossal duct cyst. Worldwide only about 150 cases are known. We describe our diagnostic and therapeutic procedures employed and included tumor excision, bilateral neck dissections and total thyroidectomy. No abnormalities in the thyroid gland but a metastatic carcinoma was uncovered in an ipsilateral lymph node in the jugular foramen area. A preoperative (99) Tc-thyroid scan and MRI study had not shown any evidence for a malignant tumor. The therapeutic approach advocated in literature is controversial but the intraoperative findings in our patient supported our decision to choose a relatively radical but not mutilating therapy.

Adult↗
PubMed2004

[Interest of thyroïdectomy in the management of thyroglossal duct cysts].

PURPOSE OF STUDY: To discuss the authors' experience with thyroglossal duct (TD) carcinoma and expose the interest of the thyroidectomy in the management of this entity. PATIENTS AND METHODS: A retrospective review of all patients with the diagnosis of TD operated on from 1985 to 2002 was performed. RESULTS: Four cases of papillary TD carcinoma were identified. Two patients were treated by a Sistrunk procedure associated with total thyroidectomy. One patient needed a thyroidectomy fifteen years after the initial management of the papillary thyroglossal duct carcinoma. The last patient had a medical treatment, with no evidence of complication after eleven years of follow up. CONCLUSION: A microscopic focus of papillary carcinoma, without cyst wall invasion, can be managed by a Sistrunk procedure, with the need for long-term follow up. Treatment of all other thyroglossal duct papillary carcinomas should include thyroidectomy followed by radioactive iodine treatment.

Adult↗