Thyroglossal duct cysts: anatomy, embryology and treatment

Chou, Jackie; Walters, Andrew; Hage, Robert; Żurada, Anna; Michalak, Maciej; Tubbs, R. Shane; Loukas, Marios

doi:10.1007/s00276-013-1115-3

Cited by 79 publications

(84 citation statements)

References 34 publications

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“…The thyroid gland originates as an invagination of proliferating endodermal cells in the floor of the pharynx during the fourth week of embryonic development [1][2][3][4][5]. As the thyroid anlage descends, it maintains an attachment to the site of what will become the foramen cecum known as the thyroglossal duct.…”

Section: Discussionmentioning

confidence: 99%

“…As the thyroid anlage descends caudally in the neck, it is thought to form a duct that remains connected to its point of origin at the level of the foramen cecum of the tongue [1][2][3][4][5]. The thyroglossal duct typically involutes and atrophies between 7 and 10 weeks gestation following migration of the primitive thyroid to its final pretracheal position in the inferior neck.…”

Section: Introductionmentioning

confidence: 99%

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A Clinicopathologic Series of 685 Thyroglossal Duct Remnant Cysts

Thompson¹,

Herrera²,

Lau³

2016

Head and Neck Pathol

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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 %).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Clinicopathologic Series of 685 Thyroglossal Duct Remnant Cysts

Thompson¹,

Herrera²,

Lau³

2016

Head and Neck Pathol

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“…In a minority of individuals, the thyroglossal duct does not undergo complete involution. Persistent remnants of the thyroglossal duct may manifest clinically as thyroglossal duct remnant cysts (TGDCs), characteristically presenting as a mobile midline anomaly in the anterior neck [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Thyroglossal Duct Cyst Carcinomas: A Clinicopathologic Series of 22 Cases with Staging Recommendations

Thompson

Herrera

Lau³

2016

Head and Neck Pathol

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Carcinomas arising from thyroglossal duct remnant cysts (TGDCs) are rare, without well-defined management and staging criteria. All TGDCs (n = 685) diagnosed between 2005 and 2015 were retrospectively reviewed, with 22 carcinomas identified (3.2 % incidence). Twenty-two patients (17 females, 5 males), aged 12-64 years (mean 39.9 years; median 39 years) were identified. An anterior, superior midline neck mass was the presenting symptom in all patients. A cancer diagnosis [all papillary thyroid carcinoma (PTC)] was made after the Sistrunk procedure (SP), with a Bethesda Category V or VI classification preoperatively by fine needle aspiration in 5 of 12 cases tested. A SP was performed in all patients, with total thyroidectomy concurrently (n = 4) or subsequently (n = 12). A selected neck dissection was performed in 5 patients, with metastases found in 3. Of the patients who had a thyroidectomy, syn-

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“…1,2 El esbozo de la glándula tiroides aparece en la 4 ta semana de gestación. 3 Durante su descenso hasta la porción baja del cuello, el esbozo medial se elonga y forma el conducto tirogloso (CT).…”

Section: Introductionunclassified

“…Su involución se completa entre la 7 ma y la 10 ma semana. 1 La falta de obliteración del CT antes de la formación mesodérmica del hueso hioides deviene en su persistencia. 2 La PCT puede encontrarse en cualquier punto del trayecto de migración del primordio desde el foramen ciego en la lengua hasta el istmo de la glándula tiroides.…”

Section: Introductionunclassified

Experiencia en el manejo de la patología del conducto tirogloso: serie de casos

et al. 2016

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Arch Argent Pediatr 2016;114(5):e310-e313 / e310Presentación de casos clínicos RESUMEN La patología del conducto tirogloso constituye la segunda anomalía cervical benigna más frecuente en la infancia. El diagnóstico es principalmente clínico. Sistrunk fue quien describió la técnica quirúrgica considerada de elección para el tratamiento definitivo de esta patología. INTRODUCCIÓNLa patología del conducto tirogloso (PCT) constituye la segunda anomalía cervical benigna más frecuente en pediatría, luego de las adenopatías, que representan el 70%-75%. 1,2El esbozo de la glándula tiroides aparece en la 4 ta semana de gestación. 3 Durante su descenso hasta la porción baja del cuello, el esbozo medial se elonga y forma el conducto tirogloso (CT). Su involución se completa entre la 7 ma y la 10 ma semana. 1 La falta de obliteración del CT antes de la formación mesodérmica del hueso hioides deviene en su persistencia.2 La PCT puede encontrarse en cualquier punto del trayecto de migración del primordio desde el foramen ciego en la lengua hasta el istmo de la glándula tiroides. 4 Cuando se localiza sobre el cartílago tiroideo, generalmente, se encuentra lateralizado, más frecuente a la izquierda.Según la relación con el hioides, el quiste puede encontrarse suprahioideo (23%), en la región hioidea (60%) (anterior o posterior a él) o infrahioideo (13%). Los quistes intralinguales representan el 3%.2 Las variantes anatómicas, en la literatura, se mencionan como reporte de casos, y no se puede establecer su verdadera incidencia. Se destacan, además del quiste intralingual, la comunicación con el lóbulo piramidal de la tiroides y la fusión tirohioidea. En ocasiones, puede infectarse y es necesaria antibioticoterapia y/o drenaje previo al tratamiento definitivo. POBLACIÓN Y MÉTODOSEstudio descriptivo retrospectivo. Se incluyeron pacientes de entre 0 y 18 años de edad, con diagnóstico histopatológico de PCT, operados en el Servicio de Cirugía Pediátrica del Hospital Italiano de Buenos Aires entre junio de 2008 y agosto de 2015. Se revisaron las bases de datos y las historias clínicas electrónicas. Se analizaron las siguientes variables: sexo, edad, infección preoperatoria, porcentaje de recidiva, estudios complementarios, técnica quirúrgica, estadía posoperatoria y variantes anatómicas. Nuestro protocolo diagnóstico se basa en el examen físico y la ecografía en todos los pacientes.

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Thyroglossal duct cysts: anatomy, embryology and treatment

Cited by 79 publications

References 34 publications

A Clinicopathologic Series of 685 Thyroglossal Duct Remnant Cysts

A Clinicopathologic Series of 685 Thyroglossal Duct Remnant Cysts

Thyroglossal Duct Cyst Carcinomas: A Clinicopathologic Series of 22 Cases with Staging Recommendations

Experiencia en el manejo de la patología del conducto tirogloso: serie de casos

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