SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
We describe an adult patient who had stridor and dyspnea as initial symptoms of a thyroglossal duct cyst. Spirometry and noninvasive imaging techniques have been useful for diagnosis of this condition.
Explore the source record for details and available documents.
A case of papillary thyroid carcinoma arising in a thyroglossal duct cyst is reported. The tumour is rare and is usually not suspected pre-operatively, and it is almost invariably only on histological examination that it is diagnosed as malignant. The clinical and pathological features are reviewed and management is discussed.
Seven infants with group B streptococcal (GBS) cellulitis-adenitis were compared with nine previously described patients. The clinical features of infection included a mean age at onset of five weeks, a male predominance (75%), a history of poor feeding or irritability (94%), and a rapid resolution with appropriate antimicrobial therapy. Bacteremia occurred in 94% of the patients. Type III GBS were associated with 75% of these infections; no antibody response to the capsular antigen of these organisms was detected in convalescent sera. Two of our cases had previously unreported sites of involvement, inguinal lymph nodes and a thyroglossal duct cyst. Four infants (80%) with typical facial or submandibular GBS cellulitis had ipsilateral otitis media at the time of admission. Otitis media with subsequent lymphatic spread to facial or submandibular areas, rather than primary bacteremia, may explain the pathogenesis of these unusual infections.
Two cases of papillary carcinoma arising in thyroglossal duct cysts are reported. Electron microscopic studies were done on both cases and similar ultrastructural features were noted. When compared with a case of papillary adenocarcinoma arising in the thyroid gland proper, no difference was seen both at the light microscopic and ultrastructural levels.
Two patients with thyroglossal duct nodes are described. Both patients were suffering from autoimmune thyroiditis. The tumours resembling thyroglossal duct cysts presented as palpable nodes in the midline of the neck and moved upwards on swallowing. Both patients had normal serum thyroxine levels and slightly elevated TSH. To avoid unnecessary surgery, a diagnostic work-up with echography and fine needle aspiration cytology of the tumour is recommended.
Congenital midline cervical cleft (CMCC) is a rare disorder of the ventral neck that is clinically evident at birth and must be differentiated from the more common thyroglossal duct cyst. The case of CMCC presented here was associated with chromosomes 13/14 de novo Robertsonian translocations as well as midline deformities including a sacral tuft and a minor tongue-tie. The case is presented as well as discussion of histopathology, embryology, and surgical treatment.
A retrospective review of 177 neck masses in childhood treated between January 1975 and December 1990 at the "Bambino Gesù" Pediatric Hospital of Rome is presented, with particular emphasis on recurrences and their causes. 105, object of our study, were thyroglossal duct cysts (TDC) (58.7%); in the remaining 72 cases there were dermoid cysts (23.1%), granulomas (7.9%), lateral neck masses (1.69%) and other histological patterns. The aim was to identify the variables that could change postoperative hospitalization or cause the recurrence. The TDC's group was separated in two: 92 primary patients, while 13 received a preliminary operation in other institutions. In the first group we applied 41 Sistrunk, 43 Schlange, 8 cystectomies; 5 recurrences occurred (5.43%), 3 of which in patients operated on with modified Sistrunk's technique (Schlange) (60%). In the second group (13 patients) a standard Sistrunk procedure was always performed. We had only one recurrence (7.69%) due to a remnant of multiple proximal thyroglossal duct. In 11 cases (10.47%) there were postoperative complications due to an existing inflammatory condition of the TDC (8 patients -72.72%). In only one case there was a recurrence after 27 months. Histological study of the specimens showed that thyroglossal ducts were frequently multiple and widely spaced and may also be present in the distal portion of the duct; in our series in 16.19% we found the distal portion of the duct during the operation. Our overall recurrence frequency is 5.7%. Every lesion referred to a TDC must be treated with a Sistrunk procedure for the better results achieved with this surgical approach but, in our experience, we prefer to complete the Sistrunk's technique with the research and exeresis of the distal portion of the duct by a "muscular sparing procedure" that preserves little patients from pharyngodynia. At the follow-up, we have not recurrence in the 17 cases operated on by this procedure.
OBJECTIVE: To describe a patient with a rare presentation of Graves' disease in the cervical thyroid and thyroglossal duct remnant. METHODS: We present a detailed case report, including initial manifestations, laboratory findings, and radiologic evaluation of a patient with Graves' disease. A review of the relevant medical literature is included. A search for articles in the MEDLINE database from 1966 to November 2003 was performed with use of the following key words: thyroglossal duct remnant, thyroglossal duct cyst, thyrotoxicosis, Graves' disease, hyperthyroidism, and ectopic thyroid tissue. The reference lists from the articles obtained from the MEDLINE database were then reviewed for other pertinent articles. English abstracts of non-English articles were also reviewed. RESULTS: A 63-year-old woman presented with thyrotoxicosis. Examination of her neck was notable for a 3.5-cm soft, mobile midline mass overlying the thyroid cartilage. She had no extrathyroidal manifestations of Graves' disease. The rest of the physical examination was unremarkable. Laboratory studies revealed a thyrotropin (thyroid-stimulating hormone) level of 0.01 microIU/mL (normal range, 0.3 to 6.6) and free thyroxine level of 4.7 ng/dL (normal range, 0.6 to 1.5). An ultrasound study showed a normal-appearing thyroid and an infrahyoidal neck mass (3.0 by 1.7 cm). A radioiodine (123I) thyroid scan demonstrated diffuse homogeneous uptake throughout the gland in conjunction with 66.6% uptake at 24 hours. In addition, a large rounded area of increased activity slightly left of the midline was noted. The left anterior oblique image showed that this area was not continuous with the left upper pole. We thought that this finding represented a hyperfunctioning thyroglossal duct cyst or remnant tissue. Our patient subsequently underwent radioiodine therapy with 15.56 mCi of 131I. A review of the English-language literature revealed only rare case reports of thyrotoxicosis in ectopic thyroid tissue. CONCLUSION: Although the occurrence of thyrotoxicosis is common, to the best of our knowledge this is only the second case of Graves' disease involving the thyroglossal duct remnant reported in the English literature.
Ectopic thyroid is an uncommon embryological aberration characterized by the presence of thyroid tissue in a site other than in its usual pre-tracheal region. It occurs along the path of descent of the developing thyroid primodium from the foramen cecum. It most commonly presents itself as a lingual thyroid and is the only thyroid in 70% of all cases. It is extremely rare for two ectopic foci of thyroid tissue to be present simultaneously. The authors report a recent case of dual ectopic thyroid present in the lingual and infrahyoid areas with no thyroid tissue in the pre-tracheal area in a 15-year-old girl. The patient had originally been scheduled for surgery under the impression of thyroglossal duct cyst; however, a pre-operative computed tomography scan of neck and thyroid scans revealed the presence of dual ectopic thyroid, thus preventing unnecessary surgery. Therefore, thyroid scan, along with either neck CT or neck ultrasonogram, should be performed routinely to avoid unnecessary surgery if the clinical picture is at all compatible with thyroid ectopia.
Explore the source record for details and available documents.
In childhood, tumors and tumor-like lesions of the neck are rare and tend to be benign. Very common are congenital cystic lesions (thyroglossal duct cysts, branchial cysts, dermoid cysts, lymphangiomas, cystic hygromas). Common neoplastic lesions are hemangiomas and papillomas. The most common malignant tumors in the head and neck region are lymphomas and rhabdomyosarcomas. Lymph node enlargements, reactive or/and infectious, account also for a significant amount of cervical masses.
The occurrence of carcinoma of the thyroglossal duct remnant (TDRCa) is reported to be less than 1%. We retrospectively analyzed 18 cases (14 females, 4 males; mean age, 38.17 years) of TDRCa who underwent surgery in our department, to evaluate the correct workup for diagnosis and treatment. Nine patients underwent a total thyroidectomy and a Sistrunk procedure (SP) whereas 8 underwent a completion total thyroidectomy after a postoperative diagnosis of TDRCa. One patient was diagnosed with TDRCa several years after total thyroidectomy for goiter. Postoperatively all patients were given radioiodide and levothyroxine therapy. Mean follow-up was 85 months. No patient died of tumor-related disease. Thyroglossal duct neoplasms were represented by papillary carcinoma in 16 cases; thyroid histology demonstrated papillary carcinoma in 6 cases (33.3%). Three patients demonstrated single regional node metastasis and only one of them demonstrated the presence of malignant thyroid disease. When clinical diagnosis of thyroglossal duct cyst is made, the workup should be completed by ultrasound (US) scan and fine-needle aspiration cytology (FNAC) in order to plan the correct surgery for a possible TDRCa. Total thyroidectomy should always be considered with SP to permit the correct treatment and follow-up in those patients. Long-term survival of patients with cTDRCa is excellent.
Mycobacterial infections, once relatively rare in North America have recently shown an upsurge with the influx of Asian and African immigrants. The infections are usually due to M. tuberculosis and present with pulmonary symptoms. However, an uncommon presentation is that of a mass in the head and neck region without any pulmonary manifestations. Although these infections are usually secondary to invasion by "atypical" mycobacteria, unusual presentations due to mycobacterium tuberculosis have been noted. Case reports depicting the very rare presentations of M. tuberculosis in the thyroglossal duct cyst, parotid, and submandibular lymph node are described. A very unusual case of atypical mycobacteria in the larynx is noted and cervical adenitis is also included. The initial subtle presentation emphasizes the importance of mycobacteria in the differential diagnosis of lesions in the head and neck region.
The development of thyroid tissue can occur in any moment of the migration of the thyroid along the thyroglossal duct from the tongue, resulting in lingual (at tongue base), sublingual (below the tongue), prelaryngeal (in front of the larynx), and substernal (in the mediastinum) ectopy. Thyroglossal duct cyst is the most common type of clinical abnormality related to thyroid ectopy. Surgical removal of such ectopic tissue is justified since some Authors describe thyroid cancer arising from aberrant thyroid tissue. The Authors report a case of thyroid ectopy in a patient who underwent 20 years before a left thyroid resection with isthmectomy; during the operation the surgeon described a hypertrophic pyramidal lobe which was left in situ and the patients did not receive any hormone suppressing therapy.
Thyroglossal duct cysts (TDCs), the most common congenital cervical abnormality, originates from the medial anlage of the thyroid gland and presents as a painless asymptomatic midline suprahyoid mass. It does not represent a diagnostic challenge. The tract may persist as a fibrous cord or leave nests of cells anywhere along its embryonic path, and it gives rise to the development of TDC. The Sistrunk operation described in 1920 consists of en bloc cystectomy and central hyoidectomy, with tract excision up to the foramen cecum. This procedure remains an effective treatment for TDC. Malignant degeneration of TDC is rare (0.7%).
Thyroglossal duct cysts (TDCs) are common congenital abnormalities of thyroid development. Carcinoma occurs rarely in patients with TDCs. In a large case series drawn from medical records at a health maintenance organization from 1971 through 1995, 14 cases of carcinoma in a TDC were found. This represents the largest known reported case series to date. Demographics, diagnosis, and treatment methods are reviewed. We recommend the Sistrunk operation and evaluation of the thyroid gland and neck for potential abnormality that would necessitate thyroidectomy and lymph node dissection. Long-term follow-up incorporating clinical examination is mandatory.
OBJECTIVE: To explore the clinic characteristic, diagnosis and treatment of ectopic thyroid gland (ETG) and avoid the misdiagnosis and mistherapy of ETG. METHOD: The clinic materials of 4 cases with ETG were analysed. Four patients were misdiagnosed thyroglossal duct cyst. The clinical features, diagnosis and management of ETG were discussed. RESULT: All of patients had a normal thyroid gland in the neck and underwent a surgical resection of neck mass. Postoperative pathologic examination revealed the neck masses originated from accessory thyroid gland, of them, 1 gland enlargement, 1 adenoma and 2 adenocarcinoma. Fortunately, by the postoperative fellow up, no significant complication was found in the patients. CONCLUSION: The well understanding of ETG and the detailed examination before surgical treatment of neck mass, including ultrasonography, CT or MRI, radioactive isotope scanning and fine needle aspiration biopsy, are keys to adequate diagnosis and management of ETG.