Thyroglossal duct cysts (TGDC)
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| Thyroglossal Duct Cyst |
What is thyroglossal duct cyst?
The most common congenital neck mass in the midline of the neck is thyroglossal duct cysts. Thyroglossal duct cyst is caused by the fact that the thyroid gland does not disappear after it has completed its embryonic development and becomes cystic. They constitute approximately 75% of the midline masses of the neck seen in childhood and are more common than those of other congenital masses.Thyroglossal duct cyst and risk of malignancy
Thyroglossal duct cysts are mostly in the midline of the neck and swollen by swallowing, they may be fistulized to the skin in this case, then take the name of thyroglossal fistula). Many malignancies may develop from the thyroglossal duct cyst (papillary, follicular, anaplastic thyroid cancer and Hurtle cell carcinomas, etc.). Because of the risk of malignancy, its treatment is surgery. Sistrunk operation is the gold standard in surgery. In the sistrunk operation, the hystoid bone corpus is removed with the entire cyst tract....Cause thyroglossal duct cyst?
Thyroglossal duct cysts are caused by a partial or complete obliteration of the duct. Generally, these anomalies that appear in cyst formation are called as thyroglossal fistula if they are opened on the skin of the neck. Although these cysts can be seen at every stage of life, they occur most frequently in the first decade and the frequency of women and men is equal. Thyroglossal duct cysts may be at any level between the thyroid and the tongue root along the thyroglossal duct. They are located in the midline and midline near the neck.The anomalies of the thyroglossal duct are caused by a partial or complete obliteration of the thyroglossal duct. These anomalies, which are generally seen as cysts, are called as thyroglossal fistula if they open to the neck skin. These anomalies, which are seen equally in both sexes, can be seen in every decade of life, but they attract attention in the childhood and especially in the first five years of life. Trigoglossal duct residues have been reported in approximately 7% of the adult population.
Symptoms of thyroglossal duct cyst
Mostly, a small swelling in the midline of the neck, but does not show any inflammation if the inflammation on the mass of redness, pain, mass growth and mass can discharge from the mass. Very rarely it can cause swallowing and breathing difficulties. The movement of the mass with swallowing and tongue movement is an important finding.In which region is thyroglossal duct cyst most commonly seen?
Due to the embryological source, the thyroglossal duct cyst is generally in the midline of the neck, which is not too soft and is moving with the tongue pulling out. These cysts can be found anywhere from the base of the tongue to the suprasternal notch (in the foramen cecum of the tongue, above or below the hyoid, near the thyroid gland or in the jugulum). However, 75% of cases are found below the hyoid bone in the neck. Thyroglossal duct cysts generally have four localizations, including intralingual (2%), suprahiyoid (25%), thyroidoid (60%), and suprasternal (13%). In our cases, localization of 65.6% thyroioid region was determined in accordance with the literature. In only one case, the thyroglossal duct cyst was found to be intralingual.Infected thyroglossal duct cysts
Approximately 50% of the thyroglossal duct cysts become infected. This is the main reason for patients to apply to the physician. However, cysts presenting with intralingual or suprahyoid localization may cause drowsiness, dysphagia or voice changes.Diagnosis of thyroglossal duct cyst
In the diagnosis of thyroglossal duct cysts, anamnesis and physical examination findings as well as fine needle aspiration biopsy (FNAB) and imaging methods can be used. A small amount of cells is seen in the results of FNAB report and the numerical overexpression of inflammatory cells from epithelial cells supports the diagnosis of thyroglossal duct cyst.Differential diagnosis of thyroglossal duct cyst
Differential diagnosis of thyroglossal duct cysts with dermoid cyst, thyroid pyramidal lobe, thyroid adenoma, thyroid carcinoma, aberrant thyroid tissue, branchial cleft cyst, lipoma, lymphadenopathy, hemangioma, lymphangioma, laryngocele and teratoma are required. Computed tomography (CT), magnetic resonance (MR), USG and thyroid scintigraphy can be used in the diagnosis and differential diagnosis of thyroglossal duct cysts. USG is the most commonly used method because of its low cost and sufficient information. Thyroid scintigraphy can be performed to differentiate the presence of ectopic thyroid tissueTreatment of thyroglossal duct cyst
Surgery is accepted in thyroglossal duct cysts. Cyst should be excised under elective conditions as 50% of cases develop infection and some of these patients are at risk of malignancy. These patients should be followed up and the possibility of transformation into malignancy should be kept in mind. The most common surgical method for the treatment of thyroglossal duct cysts is Sistrunk Operation. In this surgical method, ductus trachea and hippoid bone are removed.Reasons for failed treatment of thyroglossal duct cyst
There are many reasons for unsuccessful surgical treatment of thyroglossal duct cyst. It is clear that a false surgical procedure such as cystectomy alone has a primary cause for high recurrence rate. It has been suggested that factors such as young patient, infection and perforation of the cyst during surgery also help relapse.Similar links >> Infected Thyroglossal Duct Cyst on The Neck / Lipoma On The Neck Symptoms, Causes, Diagnosis and Treatment / Branchial Cleft Cyst Definition, Symptoms, Diagnosis and Treatment
Source links >> Thyroglossal Duct Cyst - StatPearls - NCBI Bookshelf / Thyroglossal duct cysts: How they form, symptoms, and diagnosis / Thyroglossal duct cyst | Radiology Reference Article | Radiopaedia.org
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
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