Midline Neck Mass Research Articles

Diagnostic Accuracy of Midline Pediatric Neck Masses.

To assess clinical evaluation, ultrasound, and previously published predictive score at preoperatively diagnosing midline neck masses and demographic or clinical associations that aid in differentiation of thyroglossal duct and dermoid cysts. Retrospective chart review. Tertiary care children's hospital. Patients <18 years undergoing primary midline neck mass surgery with histopathologic diagnosis of thyroglossal duct or dermoid cyst who had preoperative ultrasound performed were included. An electronic medical record query generated 142 patients whose histopathologic diagnosis was thyroglossal duct cysts (TGDCs) or dermoid cysts (DCs). Charts were reviewed for demographic and clinical features. A radiologist blindly reviewed patients' ultrasounds for SIST (septae + irregular walls + solid components = thyroglossal) score components. Each patient received 3 preoperative diagnoses: clinical, ultrasound, and SIST. Statistical analyses were conducted to determine association of demographic, clinical, or radiographic variables with diagnoses. Specificity, sensitivity, and predictive values were evaluated for each candidate diagnosis. There were 83 TGDCs and 59 DCs. Tenderness, infection history, depth relative to strap muscles, and SIST components were more common among TGDCs. Sensitivity and positive and negative predictive values surpassed 63% for each diagnostic modality. SIST score outperformed other diagnostic modalities with sensitivity, positive predictive value, and negative predictive value of 84%, 91%, and 81%, respectively. Clinical and ultrasound assessments were largely inconclusive for dermoid cysts, but SIST correctly identified 89% of DCs. SIST score was the most accurate predictor of pediatric midline neck masses. Clinical and radiographic findings may help guide preoperative diagnosis, although further evaluation is required to develop more efficacious diagnostic tools.

Dermoid Cyst of the Parotid Gland: A Rare Entity.

Dermoid cysts of the head and neck are a rare entity. These cysts are benign cystic malformations and histologically composed of tissues originating from ectoderm and mesoderm. Dermoid cysts usually presents as midline neck mass and rarely appear in lateral region. These are extremely rare in parotid gland, however should be considered as a differential in the list of parotid mass. There are a few cases published till date. Superficial parotidectomy is suggested as surgical treatment, however sometimes enucleation is also sufficient. There are only very few case reports published on dermoid cysts in parotid glands. We present a rare case of this entity and the challenges faced in making diagnosis with a short review of the literature.

Invasive primary papillary carcinoma in a thyroglossal duct cyst: A case report and review of the literature

PatientFemale, 46. Clinical procedureSistrunk's procedure, Total Thyroidectomy and excision of the cervical lymph nodes. BackgroundThyroglossal duct cyst is the commonest congenital anomaly of the thyroid gland. Occurrence of malignancy in a thyroglossal duct cyst is considered a rare condition, forming 1% of all cases of thyroglossal duct cyst. Here in the current report we presented a rare case of primary papillary carcinoma which arise in a thyroglossal duct cyst and a review of the literature. Case reportOur case is a 46-year-old female patient who presented with a painless cystic mass in front of the neck. After initial physical examination we have performed fine needle aspiration cytology (FNAC) of the cyst which revealed a papillary neoplasm. The patient underwent total thyroidectomy with excision of the cervical lymph nodes and surgical excision of the thyroglossal duct cyst (the Sistrunk's procedure). Histopathology of the specimen revealed a thyroglossal duct cyst which contains a primary invasive papillary carcinoma that infiltrated the cyst wall. The thyroid gland was normal, most of the cervical lymph node was positive for PTC. ConclusionsPrimary papillary carcinoma of thyroglossal duct cyst is a rare condition that should be considered in patients with cystic midline neck masses. Surgery and radical excision is the optimal patient management to improve survival.

Dual ectopic thyroid associated with thyroid hemiagenesis.

SummaryWe report a case of a 15-year-old girl with a midline neck mass that was first noted 2 or 3 years previously. She had been treated with levothyroxine (L-T4) for congenital hypothyroidism until 11 years of age. Ultrasonography revealed an atrophic right thyroid (1.0 × 1.6 × 2.6 cm in size) and a mass (2.3 × 1.0 × 3.5 cm in size) in the upper part of the neck. No left lobe of the thyroid was detected. On further evaluation, Tc-99m pertechnetate thyroid scintigraphy and CT showed ectopic thyroid tissue in the lingual region and infrahyoid region. Thus, she was diagnosed as having dual ectopic thyroid and thyroid hemiagenesis. The atrophic right thyroid was thought be non-functional. Treatment with L-T4 was started to reduce the size of the dual ectopic thyroid tissue. This may be the first reported case of dual ectopic thyroid associated with hemiagenesis detected only by ultrasonography.Learning points:Ultrasonography can confirm the presence or absence of orthotopic thyroid tissue in patients with ectopic thyroid.The cause of congenital hypothyroidism should be examined.Clinical manifestation of ectopic thyroid may appear when the treatment with L-T4 is discontinued.Annual follow-up is needed in all children when their thyroid hormone replacement is stopped.

Ratio of height-to-thyromental distance and ratio of height-to-sternomental distance as predictors of laryngoscopic grade in children.

Background and Aims:Failure to secure the airway is an important cause of morbidity and mortality in children. Children are often uncooperative for routine examination and pose problems for obtaining external measurements. We aimed to evaluate ratio of height-to-thyromental distance (RHTMD) and ratio of height-to-sternomental distance (RHSMD) as predictors of laryngoscopic grade in children aged 1–12 years.Material and Methods:This study was an observational study conducted in children aged between 1 and 12 years scheduled for elective surgery under general anesthesia. Children unable to stand, having limited mouth opening/neck mobility, cleft palate or with midline neck masses were excluded. Weight, height, and thyromental and sternomental distances were measured preoperatively. Following induction of anesthesia and full-muscle relaxation, laryngoscopy was performed and Cormack–Lehane view with Cook's modification was noted. Receiver operating characteristic (ROC) curve analysis using RHTMD and RHSMD was performed for predicting poor laryngoscopic view.Results:A total of 138 children with mean age of 6.6 ± 3.4, RHTMD of 17.7 ± 2.1, and RHSMD of 10.0 ± 1.0 were included. No Grade 3 or 4 laryngoscopic views were obtained. ROC curve analysis was done for predicting 2b view (restricted), incidence of which was 10.1%. RHTMD was a better predictor of 2b laryngoscopic view with an area under curve (AUC) of 0.792 compared to RHSMD (AUC = 0.463).Conclusions:In children aged 1–12 years, RHTMD is a better predictor of restricted view compared to RHSMD.

A Case of Unusual Type of Branchial Cleft Cyst Presenting as Superficial Midline Neck Mass

A Case of Unusual Type of Branchial Cleft Cyst Presenting as Superficial Midline Neck Mass

Bronchogenic Cyst in the Head and Neck Region.

The objective of this study was to review the clinical characteristics and surgical treatment outcomes of patients with bronchogenic cysts in the head and neck region. A retrospective chart review was performed at Chonnam National University Hwasun Hospital from January 2006 to May 2016. Eight patients with a final diagnosis of bronchogenic cyst in the head and neck region were identified based on their medical records. The most common location for the head and neck lymphatic malformations was the neck (4 patients), followed by the soft palate (1 patient), the posterior pharyngeal wall (1 patient), the floor of mouth (1 patient), and the arytenoid (1 patient). The size of the lymphatic malformations ranged from 1 to 6 cm. Bronchogenic cysts recurred in 2 patients. Both these patients were disease-free after the revision operation. No major complications resulting from the surgical intervention were observed. Bronchogenic cysts are rare congenital malformations and they can occur at various sites in the head and neck region. Bronchogenic cyst should be considered in the differential diagnosis of midline and lateral neck masses or intraoral cysts.

An Intra-Thyroid Thyroglossal Duct Cyst - A Case Report

Abstract Thyroglossal cysts develop from a persistent portion of the thyroglossal tract and are the most common cause of midline neck masses. It can occur anywhere along the path of the thyroid gland from the base of the tongue to the suprasternal notch. However, intra-thyroid thyroglossal duct cyst in an adult is rare finding. We present the case of a 50-year male presented with a cystic thyroid nodule due to an intrathyroid thyroglossal duct cyst. Pathologic analysis revealed the cyst to be lined by a squamous epithelium consistent with a thyroglossal duct cyst surrounded by normal thyroid tissue. Although pathogenesis of an alone thyroglossal duct cyst in the thyroid remains unknown, this case suggest that thyroglossal duct cyst should be considered in the differential diagnosis of a thyroid nodule.

Thyroglossal Duct Cyst Carcinomas in Pediatric Patients: Report of Two Cases with a Comprehensive Literature Review

Thyroglossal duct cyst (TGDC) carcinomas are rarely encountered in the pediatric population. The clinical behavior of these tumors in the pediatric setting is unclear and management is not well defined. Two cases of pediatric thyroglossal duct cyst carcinoma were identified in a review of all thyroglossal duct cysts diagnosed over a ten year period. These two cases were analyzed along with 57 cases of thyroglossal duct cyst carcinoma affecting patients less than 21years of age compiled from the English literature. Fifty-nine patients (36 females, 23 males) aged 6-20years (mean 15.0years) were identified. All presented with an anterior midline neck mass, which was typically mobile and non-tender. The average tumor size was 2.6cm. Histologically, all tumors were papillary thyroid carcinomas arising in a background of a thyroglossal duct cyst. The tumors exhibited a papillary, follicular, or mixed architecture with classical papillary thyroid carcinoma nuclear features. Soft tissue extension was present in 16 cases. All patients were managed surgically with a Sistrunk procedure, with additional thyroidectomy performed in 29 patients, combined with a lymph node dissection (n = 15), or a Sistrunk and lymph node dissection (n = 5). All patients were stage I at presentation, with 11 showing lymph node metastases. Postoperative radioactive iodine was employed in 20 patients. A papillary carcinoma of the thyroid gland was reported in four of the patients who had concurrent/subsequent thyroidectomies. Recurrences were reported in four patients, with distant metastases in one patient, who died of disease (13months). Follow up data was available for 45 patients, with an overall mean follow-up of 54.5months. All patients were alive, with the exception of one who died with disease. TGDC carcinomas in pediatric patients is associated with a good overall prognosis, best managed by Sistrunk procedure alone, with selected lymph node dissection if clinically indicated.

Outcome of treatment in patients with thyroglossal duct cyst in Zaria: Our experience

Introduction: Thyroglossal duct cyst (TGDC) is the most common congenital midline neck mass that most commonly present as gradually enlarging painless mass that moves with swallowing and protrusion of tongue, usually noticed in the first decade or in young adult. The aim of this study is to review the treatment outcome of patients with TGDC who presented to Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Materials and Methods: The record of patients managed for TGDC at the Division of Paediatric Surgery and Otorhinolaryngology of Department of Surgery Ahmadu Bello University Teaching Hospital Zaria, Kaduna, Nigeria over a 10-year period between January 2007 and December 2016 was reviewed. The information obtained included demographic characteristic and complete clinical information. The data were analyzed using a Statistical Package for Social Sciences version 21.0 software. Results: A total of 19 patients were managed for TGDC within the years under review. The age range of the patients was 2–12 years with mean age and standard deviation of 6.6 and 3.5 years, respectively. Eleven patients (57.9%) presented within 6 months to 3 years of the disease onset. The location of the TGDC in majority of our patients 15 (78.9%) was infrahyoid. Most of the patients 17 (89.5%) had uncomplicated TGDC. Fifteen (79%) of the patients had Sistrunk operation, and no case of recurrence was observed after 2 years. Conclusion: The outcome of treatment of TGDC is good, when early diagnosis and complete surgical excision of the cyst is achieved. Complete excision of the cyst without the removal of the hyoid bone may be adequate for suprahyoid cyst.

Dilemma in Managing Thyroglossal Duct Cyst Carcinoma

The thyroglossal duct cyst (TGDC) is a well-known developmental abnormality encountered in the neck. It represents over 75% of childhood midline neck masses and 7% of the adult population.

Rare Case of Patient with HIV Related Plasmablastic Lymphoma Presenting with Bilateral Parotid Involvement and Hypergammalobulemia

44 year old male with no past medical history presents with rapidly enlarging neck mass over past two months. He denied B-symptoms. Clinical examination revealed bulky midline neck mass with bilateral cervical and left supraclavicular adenopathy. 6/29/16 excisional lymph node biopsy of neck lymph node showed a monomorphic proliferation of malignant cells with large immunoblastic tumor cells with prominent nucleoli (Figure1). Neoplastic cells expressed MUM-1, CD138 (Figure 2), and were lambda light chain restricted. Neoplastic cells were negative for CD20, CD79, CD3, CD5, CD7, and BCL-2. Additionally, Cyclin D1, BCL-6, CD30, ALK-1, S100, CD56 was negative. Ki-67 was 99%. EBER by ISH was positive (Figure 3). Karyotype was normal. PET CT 7/1/16 Showed small hypermetabolic lymph nodes in the right neck, bilateral parotid gland with additional hypermetabolic activity in the left supraclavicular fossa and central neck base along with activity in the tongue base with maximum SUV 16.1. CT neck chest abdomen and pelvis 7/1/16 showed bilateral enhancing parotid lesions, large central midline neck mass with right strap muscle involvement. Also, there was soft tissue prominence of the adenoids, tonsil pillars, lingual tonsils, laryngeal ventricle. Last there was bilateral deep cervical, supraclavicular, & posterior cervical lymphadenopathy. Lumbar puncture, bone marrow biopsy, & MRI brain were negative for involvement. Labs 6/27/16: Platelet 126 10x3/µL, hemoglobin 15.7 g/dL, white blood cell 5.2 with variant lymphocytes. Uric acid 4.3 m/dL, total protein 9.3 g/dL, creatinine 1.23 m/dL, alanine aminotransferase 83 U/L, aspartate aminotransferase 83 U/L and complete metabolic panel otherwise normal. LDH 228 U/L, beta 2 microglobulin 4.5 mg/L. HIV-1 test was positive with 94316 copies/mL by PCR. CD4 count 65 cells/mcl. EBV VCA IgM <0.2 AI, EBV VCA IgG > 8.0 AI. IgG 3023 mg/dL, IgE 207IU/ML, IgA 581 m/dL, IgM 286 mg/dL, free kappa 117 mg/L, free lambda 97.94 mg/L and normal kappa/lambda ratio. SPEP with immunofixation consistent with inflammatory response. Peripheral blood flow cytometry revealed a minimal kappa predominant monoclonal B-cell population. Patient started on DA-EPOCH with prophylactic intrathecal methotrexate with excellent clinical response after first cycle. Plan for 4-6 cycles with prophylactic intrathecal chemotherapy followed by autologous stem cell transplantation. For supportive care, the patient was started on HAART therapy, acyclovir, fluconazole, Levaquin, azithromycin. To our knowledge this is the first case of bilateral parotid gland involvement in PBL. Furthermore it is unclear if the hypergammaglobulinemia is related to HIV infection vs. directly PBL related. [Display omitted] [Display omitted] [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

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

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 12-64years (mean 39.9years; median 39years) 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, synchronous PTC was identified in 6 (thus, 6 of 22 patients had synchronous thyroid gland primaries). This supports an origin from extra-thyroidal remnants (cyst origin) rather than metastatic tumor from a thyroid gland primary. Follow-up radioactive iodine therapy was performed in 13 patients. Metastatic disease to local lymph nodes 57months after presentation was seen in 1 patient, with all others alive and disease free (mean 3.8years; range 0.4-10.8years). The TGDCs ranged from 0.8 to 5cm (mean 2.3cm), while the PTCs ranged from 0.1 to 3.8cm (mean 1.4cm). All of the tumors were classical PTC, showing a sclerotic and infiltrative pattern, with a capsule present in 11. Lymphovascular invasion was detected in 11; margins were positive in 6. Using currently defined criteria, the patients were separated into AJCC stage group I (n=21) or II (n=1). However, if extension into the adipose tissue (n=11), skeletal muscle (n=10), or perineural/perivascular tissues (n=10) were used to stage the patients, interpreted to represent the equivalent of "extrathyroidal extension" (n=13) as defined for thyroid gland primaries, there would be 15 group I and 7 group III cases. All seven group III patients were ≥45years. Three of four patients with lymph node metastasis also showed soft tissue extension. In conclusion, TGDC carcinomas (TGDCCa) are uncommon, with all classical PTC. For "microcarcinomas" (≤1cm), conservative management can be used for patients <45years (i.e., Sistrunk procedure only); for >1cm tumors, and due to the high incidence of concurrent papillary carcinoma and higher stage at presentation in older patients, completion thyroidectomy is recommended for patients ≥45years. Thus, even though a good prognosis can be expected for PTC developing in TGDCs, staging is advocated to more appropriately match therapeutic interventions.

Thyroglossal duct papillary carcinoma with squamous metaplasia in a 12-year old female and review of literature

Abstract We are reporting a case of a 12-year old African-American female who presented with a six-month history of a painless, enlarging, midline neck mass. Imaging demonstrated a 4-cm solid mass with cystic components and calcifications. Differential diagnosis included dermoid tumor, teratoma, sarcomatous lesion, thyroglossal duct cyst carcinoma, and ectopic thyroid tissue with malignant transformation. Preoperative thyroid studies were unremarkable. Patient underwent Sistrunk procedure and cervical lymph node dissection. Pathology reported a diagnosis of papillary carcinoma with squamous metaplasia arising from a thyroglossal duct cyst with three of five positive lymph nodes. Post-operative thyroid studies and imaging were unremarkable. After literature review on pediatric cases of thyroglossal duct carcinomas, the decision was made to forgo thyroidectomy and opt for close follow-up. Thyroglossal duct carcinoma is a rare pediatric tumor with approximately 26 cases reported in the literature. Best practice for the extent of surgical resection and post-operative management is still evolving as we gather data on long-term outcomes.

Presentation, Management, and Outcome of Thyroglossal Duct Cysts in Adult and Pediatric Populations: A 14-Year Single Center Experience.

A thyroglossal duct cyst (TDC) is a frequent congenital midline anomaly of the neck that usually manifests during the first decade of life. We aimed to describe the presentation, management, and outcome of TDC in pediatric and adult cases. A retrospective observational analysis was conducted for all patients diagnosed and treated for TDC between 2000 and 2014 in a single center in Qatar. Data included patients' demographics, presentations, preoperative investigations, anesthesia type, histopathological findings, surgical management, recurrences, and complications. We identified 102 patients, of which 57% were males. The mean age of patients was 20.2±15.6 years. A bimodal distribution of TDC has been observed, which peaked between the ages of 6-13 years and at ≥19 years. The preoperative evaluation mainly includes ultrasonography (66%), thyroid function test (44%), and fine-needle aspiration cytology (10%). The median size of the cyst was 25 (2-60) mm. Patients mainly presented with an asymptomatic midline neck mass at or below the hyoid bone (82%), followed by fistula (9%), infection (2%), and dysphagia (2%). Eighty-nine cases were identified preoperatively as TDC. The histopathological findings confirmed TDC with hyoid bone in 61 cases, and TDC alone in 38 cases. Eighty patients underwent the Sistrunk procedure while excision of TDC alone was observed in 18 cases. Five cases of recurrent disease were also treated. Adults had a greater median cyst size (30 (9-60) vs. 22 (2-55) mm; p = 0.005) and required prolonged operation time (69 (1-169) vs. 32.5 (1-140) mins; p = 0.004) compared to the pediatric group. The occurrence of TDC shows a bimodal age distribution. Preoperative evaluation and time for surgery vary whereas clinical presentations, surgical management, and postoperative outcomes are comparable among adult and pediatric groups. Ultrasonography is the preferred diagnostic modality, and the Sistrunk procedure remains the primary choice of treatment.

Adenoid cystic carcinoma of the upper airway mimicking a thyroid tumor: A case report.

Adenoid cystic carcinoma (ACC) is a rare malignant tumor, reportedly representing <1% of all head and neck cancers. There have been few reported cases of ACC of the upper airway presenting as a midline mass. This is the case report of a 47-year-old female patient who presented with such a midline neck mass. The mass was approached and investigated as a thyroid mass, but was ultimately found to be a tracheal tumor with thyroid invasion. We herein discuss in detail the patient history, investigation and treatment.

Presentation of Thyroglossal Cyst in Children

Background: Thyroglossal duct cyst a developmental anomaly present as a congenital cervical masses of neck in children.Objectives: To observe its deferent presentation and evaluate among the children.Materials and methods: This observational cross section study conducted among patients of eighteen years of age present with thyroglossal duct cyst between 2007 to 2012 in the department of ENT and Head- Neck surgery, Dhaka Medical College Hospital, Dhaka. All patients were operated by Sistrunk operation under (excision of total cyst and removal median portion hyoid bone) under general anesthesia. All specimens were histo-pathologically confirmed.Results: Among 24 children with thyroglossal cyst, 15 boys and 9 girls with male female ratio 1.67:1, age ranged from 4 years to 18 years (mean 9.46 std ±4.27). Male (mean 7.53±4.01years) child are younger than female (mean 12.67±2.39 years) child. 66.67% male children were below 10 years of age and 88.89% female children were over 10 years of age. According to the presentation site 17(70.83%) cases were juxtra hyoid, 4(16.67%) were suprahyoid and 3 (12.50%) were infrahyoid. 23 (95.83%) were present as midline swelling, only 1(4.17%) was present as left lateral infrahyoid swelling. 4(16.67%) patient were attended as thyroglossal fistulae with history of intervention. 4(16.67%) patient were developed recurrence followed by surgical resection within two years.Conclusion: Thyroglossal duct cyst present as an asymptomatic midline neck mass around the hyoid region in children. Complete resection along with median portion hyoid bone prevents recurrence.J. Paediatr. Surg. Bangladesh 5(2): 45-53, 2014 (July)

A Clinicopathologic Series of 685 Thyroglossal Duct Remnant Cysts.

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 87years (mean 31.3years). 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 2.4cm (range 0.4-9.9cm) by imaging studies and 2.6cm (range 0.2-8.5cm) by pathologic examination; pediatric patients had smaller cysts (mean2.1cm) than adults (mean2.8cm). Histologically, 257 (38%) TGDC were lined by respiratory epitheliumalone, 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 (0.45cm 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%).

Midline Ectopic Thyroid Mimicking as a Thyroglossal Duct Cyst

Ectopic thyroid tissue is a rare developmental abnormality. A case is reported here of ectopic thyroid tissue that presented as a midline mass, mimicking a thyroglossal duct cyst. The thyroid gland was not visualized in its normal position. This report highlights the importance of imaging in the preoperative evaluation of a midline neck mass.

Papillary Carcinoma Occurrence in a Thyroglossal Duct Cyst with Synchronous Papillary Thyroid Carcinoma without Cervical Lymph Node Metastasis: Two-Cases Report.

Background. We present two rare cases of papillary carcinomas which appeared in thyroglossal duct cysts. These cases highlight that thyroglossal duct cyst can serve as malignancy of thyroid gland. Methods. A retrospective case report was carried out on 2 patients at Cipto Mangunkusumo Hospital. Results. A 57-year-old man presented with enlarged right anterior and midline neck mass, which preoperatively were diagnosed as thyroglossal duct cyst (TDC) and nontoxic multinodular goiter. A total thyroidectomy and Sistrunk procedure were performed. In the second case, a 35-year-old woman presented with a lump which occurred at anterior neck region without palpable mass at the thyroid. Preoperatively, it was diagnosed as TDC. Sistrunk procedure was performed, followed by total thyroidectomy a month after the first operation. Histopathology showed papillary thyroid carcinoma in both patients. Conclusion. The occurrence of carcinoma in TDC is very rare but should always be considered as an option in making diagnosis for a neck mass.