Objective: To clarify the preoperative diagnostic rate and elucidate the morphological features of thyroglossal duct cancer through a literature search on cases reported in Japan. Methods: A search of a medical databa...Objective: To clarify the preoperative diagnostic rate and elucidate the morphological features of thyroglossal duct cancer through a literature search on cases reported in Japan. Methods: A search of a medical database (Japan Medical Abstracts Society) identified 40 studies on thyroglossal duct cancer in Japanese patients between 1976 and 2014. A total of 47 cases, including the present case, are summarized herein. Patient characteristics, preoperative diagnosis, and morphological features were reviewed and analyzed. Morphological features of the internal portions in the cystic lesions were classified using the previously reported Yokosuka Kyosai Hospital criteria for ultrasonography findings of thyroid cystic tumors. Results: Preoperative diagnosis was described for 43 of the 47 cases. Malignancy was suspected in 18 (41.9%) of the 43 cases on the basis of fine needle aspiration (FNA) cytology (presence of suspected papillary carcinoma cells) and imaging studies (presence of calcifications), 12 and 6 cases, respectively. Preoperative FNA was performed in 24 cases with a correct diagnosis obtained in only 12 (50%) cases. Morphological features were evaluated by preoperative imaging studies and/or postoperative histopathology. We found 6 cases (15%) with solid lesions, 32 cases (80%) with cystic lesions containing a solid part, and 2 cases (5%) with solo cystic lesions, respectively. Calcification was observed in 28 (72.5%) cases. We further examined the internal morphology of 32 cases with cystic lesions according to the criteria for ultrasonography findings of thyroid cystic tumors described in Methods. Of the 32 cases, 25 (62.5%) and 7 (17.5%) were classified as “eccentric acute angle type (Ea)” and “multiseptate type (M)”, respectively. The boundary between the solid part and the cystic part was irregular in all 7 “M” cases. No “eccentric and blunt angle type (Eb)” or “concentric type (C)” lesions were observed. Conclusions: The preoperative diagnostic rate for thyroglossal duct cancer using FNA is low, and it is important that diagnosis be performed in conjunction with imaging findings. The presence of solid parts or calcified lesions classified as “Ea” or “M with irregular boundaries” on the basis of imaging findings is suggestive of malignancy.展开更多
BACKGROUND Thyroglossal duct cysts(TDC)are common congenital deformities.Most of them are cysts formed by the thyroglossal ducts that do not disappear and degenerate in the early embryonic stage.TDC exists alone and i...BACKGROUND Thyroglossal duct cysts(TDC)are common congenital deformities.Most of them are cysts formed by the thyroglossal ducts that do not disappear and degenerate in the early embryonic stage.TDC exists alone and is rarely complicated by other congenital embryonic malformations.Only a few reports of TDC with branchial cleft cysts,thyroid cancer,thyroid hematoma,and epidermoid cysts have been reported.Therefore,we report a patient with TDC and parathyroid cyst(PC),a rare disease that has never been reported.CASE SUMMARY A 47-year-old woman presented to clinic in April 2021 with a neck tumor which she had noticed 5 d earlier.We perfected the relevant examinations,such as ultrasound and computed tomography,and resected the tumor.After surgical treatment,the pathology revealed a cervical thyroglossal duct cyst and a left lobe parathyroid cyst.The patient was followed up for 1 year without significant recurrence.CONCLUSION We report a patient with a simultaneous TDC and a PC to explore the correlation between the two congenital anomalies.展开更多
<strong>Introduction:</strong> Thyroglossal duct cyst is a well-recognized congenital midline neck swelling observed in early childhood and rarely in adults. It may reveal itself as a painless cyst, absces...<strong>Introduction:</strong> Thyroglossal duct cyst is a well-recognized congenital midline neck swelling observed in early childhood and rarely in adults. It may reveal itself as a painless cyst, abscess, or as fistula. Several studies have been conducted across the world, but the literature is scarce on its presentation and complications in the Middle East. This indexing study aims to report a 10-year experience with thyroglossal duct cyst (TGDC) presentation, excision, and recurrence at a teaching hospital in Saudi Arabia (KSA). <strong>Methods:</strong> A retrospective chart review was conducted at the Armed Forces Hospital Southern Region, KSA from December 2008 to December 2018. Data were retrieved from the electronic medical record system of the hospital and validated with the histopathology records. A total of 48 patients diagnosed as TGDC, sinus or fistula were identified. Stata ver. 16.1 was used to analyze the data and results formulated using regression model and Pearson’s chi-square test. <strong>Results:</strong> The majority of our patients were female (60.4%), and the most common presentation was a midline neck swelling which moved with tongue protrusion. Surgical excision via Complete Sistrunk procedure was the operation of choice in 60.5% followed by excision of the cyst with tract and sinus tract. Previous infection and surgical history contributed to complications in our patients, but no association of age or gender was observed. Patients presenting with infected and discharging cysts were found to be much more likely to develop a recurrence (9 patients). Cysts deep to the hyoid showed more recurrence [n = 7 (78%)] compared to superficial cysts [n = 2 (22%)] and posterior and multi-tract lesions also showed significant recurrence. <strong>Conclusion:</strong> Despite being a common cause of neck swelling, thyroglossal duct cyst is often missed on physical exams. To reduce complications, timely diagnosis and treatment are necessary.展开更多
Thyroglossal duct carcinoma,which is usually diagnosed postoperatively,is a rare malignant tumor arising in the thyroglossal duct cyst.The definitive diagnosis can be made only after microscopic examination.We retrosp...Thyroglossal duct carcinoma,which is usually diagnosed postoperatively,is a rare malignant tumor arising in the thyroglossal duct cyst.The definitive diagnosis can be made only after microscopic examination.We retrospectively reviewed three cases of thyroglossal duct carcinoma diagnosed in Peking University School and Hospital of Stomatology from January 1986 to August 2006.Clinical and pathological features were investigated and the optimal treatment protocol was proposed.The constituent ratio of thyroglossal duct carcinoma among surgically excised thyroglossal duct lesions was 2.9%.The clinical presentation of thyroglossal duct carcinoma was very similar to that of its benign counterpart.Two cases were diagnosed as thyroglossal duct cyst prior to the operation,the remaining one as dermoid cyst.All three cases were diagnosed as papillary carcinoma of thyroid origin after microscopic examination.Primary thyroglossal duct carcinoma should conform to the following criteria:localization of the carcinoma to a clearly demonstrable thyroglossal duct cyst or tract;clinically or histologically confirmed absence of carcinoma of the thyroid gland.Papillary carcinoma is the most common histological type,which usually develops slowly with an excellent prognosis.The histological characteristics including:formation of papillary structure;nuclear morphological variations such as ground glass nuclei,pseudoinclusions,intranuclear grooves and filaments;concentrically calcified structures termed psammoma bodies which is regarded as a strong indication of papillary carcinoma;and positivity in immunohistological staining for thyroglobin.Sistrunk procedure of excision is the choice for treatment.A close follow-up is needed.In the presence of thyroid gland masses or cervical lymphadenopathy,thyroidectomy or neck dissection should be recommended.The effect of thyroid suppression therapy and radioactive iodine therapy is not conclusive.展开更多
文摘Objective: To clarify the preoperative diagnostic rate and elucidate the morphological features of thyroglossal duct cancer through a literature search on cases reported in Japan. Methods: A search of a medical database (Japan Medical Abstracts Society) identified 40 studies on thyroglossal duct cancer in Japanese patients between 1976 and 2014. A total of 47 cases, including the present case, are summarized herein. Patient characteristics, preoperative diagnosis, and morphological features were reviewed and analyzed. Morphological features of the internal portions in the cystic lesions were classified using the previously reported Yokosuka Kyosai Hospital criteria for ultrasonography findings of thyroid cystic tumors. Results: Preoperative diagnosis was described for 43 of the 47 cases. Malignancy was suspected in 18 (41.9%) of the 43 cases on the basis of fine needle aspiration (FNA) cytology (presence of suspected papillary carcinoma cells) and imaging studies (presence of calcifications), 12 and 6 cases, respectively. Preoperative FNA was performed in 24 cases with a correct diagnosis obtained in only 12 (50%) cases. Morphological features were evaluated by preoperative imaging studies and/or postoperative histopathology. We found 6 cases (15%) with solid lesions, 32 cases (80%) with cystic lesions containing a solid part, and 2 cases (5%) with solo cystic lesions, respectively. Calcification was observed in 28 (72.5%) cases. We further examined the internal morphology of 32 cases with cystic lesions according to the criteria for ultrasonography findings of thyroid cystic tumors described in Methods. Of the 32 cases, 25 (62.5%) and 7 (17.5%) were classified as “eccentric acute angle type (Ea)” and “multiseptate type (M)”, respectively. The boundary between the solid part and the cystic part was irregular in all 7 “M” cases. No “eccentric and blunt angle type (Eb)” or “concentric type (C)” lesions were observed. Conclusions: The preoperative diagnostic rate for thyroglossal duct cancer using FNA is low, and it is important that diagnosis be performed in conjunction with imaging findings. The presence of solid parts or calcified lesions classified as “Ea” or “M with irregular boundaries” on the basis of imaging findings is suggestive of malignancy.
文摘BACKGROUND Thyroglossal duct cysts(TDC)are common congenital deformities.Most of them are cysts formed by the thyroglossal ducts that do not disappear and degenerate in the early embryonic stage.TDC exists alone and is rarely complicated by other congenital embryonic malformations.Only a few reports of TDC with branchial cleft cysts,thyroid cancer,thyroid hematoma,and epidermoid cysts have been reported.Therefore,we report a patient with TDC and parathyroid cyst(PC),a rare disease that has never been reported.CASE SUMMARY A 47-year-old woman presented to clinic in April 2021 with a neck tumor which she had noticed 5 d earlier.We perfected the relevant examinations,such as ultrasound and computed tomography,and resected the tumor.After surgical treatment,the pathology revealed a cervical thyroglossal duct cyst and a left lobe parathyroid cyst.The patient was followed up for 1 year without significant recurrence.CONCLUSION We report a patient with a simultaneous TDC and a PC to explore the correlation between the two congenital anomalies.
文摘<strong>Introduction:</strong> Thyroglossal duct cyst is a well-recognized congenital midline neck swelling observed in early childhood and rarely in adults. It may reveal itself as a painless cyst, abscess, or as fistula. Several studies have been conducted across the world, but the literature is scarce on its presentation and complications in the Middle East. This indexing study aims to report a 10-year experience with thyroglossal duct cyst (TGDC) presentation, excision, and recurrence at a teaching hospital in Saudi Arabia (KSA). <strong>Methods:</strong> A retrospective chart review was conducted at the Armed Forces Hospital Southern Region, KSA from December 2008 to December 2018. Data were retrieved from the electronic medical record system of the hospital and validated with the histopathology records. A total of 48 patients diagnosed as TGDC, sinus or fistula were identified. Stata ver. 16.1 was used to analyze the data and results formulated using regression model and Pearson’s chi-square test. <strong>Results:</strong> The majority of our patients were female (60.4%), and the most common presentation was a midline neck swelling which moved with tongue protrusion. Surgical excision via Complete Sistrunk procedure was the operation of choice in 60.5% followed by excision of the cyst with tract and sinus tract. Previous infection and surgical history contributed to complications in our patients, but no association of age or gender was observed. Patients presenting with infected and discharging cysts were found to be much more likely to develop a recurrence (9 patients). Cysts deep to the hyoid showed more recurrence [n = 7 (78%)] compared to superficial cysts [n = 2 (22%)] and posterior and multi-tract lesions also showed significant recurrence. <strong>Conclusion:</strong> Despite being a common cause of neck swelling, thyroglossal duct cyst is often missed on physical exams. To reduce complications, timely diagnosis and treatment are necessary.
文摘Thyroglossal duct carcinoma,which is usually diagnosed postoperatively,is a rare malignant tumor arising in the thyroglossal duct cyst.The definitive diagnosis can be made only after microscopic examination.We retrospectively reviewed three cases of thyroglossal duct carcinoma diagnosed in Peking University School and Hospital of Stomatology from January 1986 to August 2006.Clinical and pathological features were investigated and the optimal treatment protocol was proposed.The constituent ratio of thyroglossal duct carcinoma among surgically excised thyroglossal duct lesions was 2.9%.The clinical presentation of thyroglossal duct carcinoma was very similar to that of its benign counterpart.Two cases were diagnosed as thyroglossal duct cyst prior to the operation,the remaining one as dermoid cyst.All three cases were diagnosed as papillary carcinoma of thyroid origin after microscopic examination.Primary thyroglossal duct carcinoma should conform to the following criteria:localization of the carcinoma to a clearly demonstrable thyroglossal duct cyst or tract;clinically or histologically confirmed absence of carcinoma of the thyroid gland.Papillary carcinoma is the most common histological type,which usually develops slowly with an excellent prognosis.The histological characteristics including:formation of papillary structure;nuclear morphological variations such as ground glass nuclei,pseudoinclusions,intranuclear grooves and filaments;concentrically calcified structures termed psammoma bodies which is regarded as a strong indication of papillary carcinoma;and positivity in immunohistological staining for thyroglobin.Sistrunk procedure of excision is the choice for treatment.A close follow-up is needed.In the presence of thyroid gland masses or cervical lymphadenopathy,thyroidectomy or neck dissection should be recommended.The effect of thyroid suppression therapy and radioactive iodine therapy is not conclusive.
