CLINICAL FEATURES OF 23 OPERATIVE CASES OF THYROGLOSSAL DUCT CYSTS INCLUDING ONE SQUAMOUS CELL CARCINOMA WITH LITERATURE REVIEW

Abstract

Twenty-three operative cases of thyroglossal duct cyst, including a case of squamous cell carcinoma, in a recent one decade were studied for clinical factors such as sex, age, duration to operation after detection of the tumor, sites, operative procedures, and postoperative course, as well as for histological findings. Moreover, a necessity of resection of the hyoid bone was discussed in terms of etiology, in conjunction with a review of the pertinent literature. As a result, no significant difference was noted in the male-to-female ratio. As to the age at the first diagnosis, most patients in the ENT and pediatric surgery fields were under 10 years old, which might reflected that the disease is congenital one. On the other hand, patients in the department of general surgery were predominantly over 20 years of age. Disease-period with less than one year was common, the lesions being frequently found between the hyoid bone and thyroid cartilage. Twenty-two cases were operated on according to Sistrunk method, of which one had recurrence but has been well for 8 years after extended reoperation. No recurrence was observed in cases without resection of the hyoid bone, however, in the literature more frequent recurrence was noted in non-resection cases compared to resection cases. Pathological recognition of a few fistels and their branches suggested the importance of wide resection of surrounding tissues as well as partial resection of the hyoid bone to prevent recurrence. We should remember a possible occurrence of papillary carcinoma derived from remnant thyroid tissues or squamous cell carcinoma deriving from fistel epithelium, though it is rare.