Sonographic demonstration of a normal thyroid gland excludes ectopic thyroid in patients with thyroglossal duct cyst.

Lim-Dunham, Jennifer E.; Feinstein, Kate A.; Yousefzadeh, David K.; Ben-Ami, Tamar

doi:10.2214/ajr.164.6.7754899

Cited by 54 publications

(49 citation statements)

References 10 publications

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“…Preoperative sonographic identification of a normal thyroid gland in patients with thyroglossal duct cyst confirms a source of thyroid hormone and excludes ectopic thyroid [15]. Routine thyroid scintigraphy is therefore not necessary if a normal thyroid gland can be identified on routine preoperative US.…”

Section: Discussionmentioning

confidence: 99%

Management of Thyroglossal Duct Cyst

Swaid¹,

Alammar²

2008

TOOTORJ

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Abstrct:Objective: Is to review our cases of Thyroglossal duct cyst (TGDC) attempting to make some conclusions that may facilitate the management of such a cases.Study Design: Twenty patients with the diagnosis of TGDC were managed between July 1996 and April 2007 in the department of Otolaryngology, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia.Results: All of our cases underwent radiological assessment before surgical intervention. Eighteen patients underwent Sistrunk procedure. In two patients the treatment was limited to removal of the cyst. In seventeen patients the clinicoradiological diagnosis was in agreement with histopathological diagnosis of TGDC. Conclusions:The diagnosis of TGDC in most of the cases is clinical. Combination of clinical assessment and imaging studies can improve the sensitivity for the diagnosis. Sistrunk's operation presented good results in our series with low rates of complications (5%) and recurrence (5.5%).

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Section: Discussionmentioning

confidence: 99%

Management of Thyroglossal Duct Cyst

Swaid¹,

Alammar²

2008

TOOTORJ

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“…12,13 The presence of a normal thyroid gland should be confirmed during a preoperative sonographic examination of a TDC because if the entopic thyroid tissue that coexists within the TDC is the patient's only functioning thyroid tissue, then a resection of the ectopic thyroid with the cyst will cause hypothyroidism. 14,15 Preoperative sonographic identification of a normal thyroid gland is sufficient to exclude a diagnosis of ectopic thyroid tissue and thus makes it possible to avoid routine thyroid scintigraphy. 15 In this study, a normal thyroid gland was confirmed in all patients.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 Preoperative sonographic identification of a normal thyroid gland is sufficient to exclude a diagnosis of ectopic thyroid tissue and thus makes it possible to avoid routine thyroid scintigraphy. 15 In this study, a normal thyroid gland was confirmed in all patients. Thyroglossal duct carcinoma, usually papillary adenocarcinoma, is an uncommon complication of TDC, occurring in less than 1% of cases.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Assessment of Thyroglossal Duct Cysts in Children

Kutuya¹,

Kurosaki²

2008

Journal of Ultrasound in Medicine

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Abbreviations BCC, branchial cleft cyst; TDC, thyroglossal duct cyst he thyroglossal duct cyst (TDC) is one of the most common congenital neck masses occurring in children, representing approximately 70% of the congenital lesions that occur in the neck. 1,2Sonography is thought to be an ideal initial technique for the differential diagnosis of a neck mass. In the past, the TDC commonly had been known to be a midline anechoic cyst at the level of the hyoid bone.3-6 However, many variations of its sonographic features have been reported. 7,8 As a result, it is important to confirm the existence of a TDC in the differential diagnosis by means of preoperative sonographic examinations, but a correct diagnosis is often difficult to make. As far as we could determine, up to now there have only been 2 statistical investigations (by Wadsworth and Siegel 7 and Ahuja et al 8 ) regarding the sonographic appearance of TDCs in children. We thus thought that an additional investigation should be performed. Therefore, in this study we assessed the sonographic appearance in 36 children with Image PresentationObjective. The purpose of this study was to clarify the sonographic features of thyroglossal duct cysts (TDCs) in children. We also investigated how the presence of inflammation influences the sonographic appearance. Methods. We reviewed the sonograms from 36 children (0.5-14 years old) with pathologically proven TDCs. The lesions were evaluated for location, shape, internal echo pattern, internal septa, wall thickness, posterior enhancement, solid components, margins, and fistulas. The sonographic features of 7 lesions that pathologically showed inflammation were also investigated. Results. Most TDCs were midline (77.8%), were located at the hyoid bone (44.4%) or were infrahyoid (38.9%), showed posterior enhancement (77.8%), were unilocular (86.1%), lacked internal septa (91.7%), and had a thin wall (75%). None had a solid component. The internal echo patterns were classified into 4 types: anechoic (25%), homogeneously hypoechoic (16.7%), pseudosolid (16.7%), and heterogeneous (41.6%). Inflammation was confirmed in 78% of the lesions with wall thickening and 100% of the lesions with internal septa. Conclusions. Most TDCs in children had echogenicity ranging from hypoechoic to heterogeneous. A thick wall and internal septa were considered to correlate with the presence of inflammation but not with the internal echo patterns of TDCs.

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“…On histological examination, ectopic thyroid may be found within the wall of the cyst with an overall frequency of !5%. It produces thyroid hormones, but the concentrations are usually subnormal and patients may be hypothyroid (28,29). Hashimoto's thyroiditis (30) and papillary carcinoma (31) have also been described.…”

Section: Other Sitesmentioning

confidence: 99%

“…Sometimes, chest radiography may also be useful in revealing some cases of intrathoracic goiter (34). Some authors, in cases such as thyroglossal duct cysts, recommend against routine use of scintigraphy due to the very low frequency of detecting ectopic tissue (29). They regard that US provides adequate information about the cyst and scintigraphy is of value only in cases of hypothyroidism or if a normal thyroid gland is not visualized on US (29).…”

Section: Diagnosismentioning

confidence: 99%

Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity

Noussios

Anagnostis²,

Goulis³

et al. 2011

European Journal of Endocrinology

312

429

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Ectopic thyroid tissue is a rare entity resulting from developmental defects at early stages of thyroid gland embryogenesis, during its passage from the floor of the primitive foregut to its final pre-tracheal position. It is frequently found around the course of the thyroglossal duct or laterally in the neck, as well as in distant places such as the mediastinum and the subdiaphragmatic organs. Although most cases are asymptomatic, symptoms related to tumor size and its relationship with surrounding tissues may also appear. Any disease affecting the thyroid gland may also involve the ectopic thyroid, including malignancy. The clinician must distinguish between ectopic thyroid and metastatic deposits emerging from an orthotopic gland, as well as other benign or malignant masses. Thyroid scintigraphy plays the most important role in diagnosing ectopy, but ultrasonography contributes as well. In cases of symptomatic disease, surgery is the treatment of choice, followed by radioiodine ablation and levothyroxine suppression therapy in more refractory cases. This review provides current understanding about the wide clinical spectrum of this rare condition, also referring to optimal diagnostic approach, differential diagnosis, and management strategies.

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Sonographic demonstration of a normal thyroid gland excludes ectopic thyroid in patients with thyroglossal duct cyst.

Cited by 54 publications

References 10 publications

Management of Thyroglossal Duct Cyst

Management of Thyroglossal Duct Cyst

Sonographic Assessment of Thyroglossal Duct Cysts in Children

Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity

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