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Congenital neck lumps
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
The diagnosis of a thyroglossal duct cyst is usually made clinically; however, imaging is essential to ensure thyroid tissue is present in the normal location. Ultrasonography is commonly used and non-invasive (see Figure 4.2). Radionucleotide thyroid imaging was previously routinely advocated and may assist in cases of diagnostic uncertainty.
Midline neck abscess
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
Given the midline location of this child's neck mass, the most likely diagnosis is an infected thyroglossal duct cyst; alternatively, an infected dermoid cyst or branchial anomaly could be present. Thyroglossal duct cysts are congenital abnormalities resulting from the failed involution of the thyroglossal duct. They are typically located over the hyoid bone and may move vertically with swallowing. Classically, patients present before 10 years of age with a painless midline neck mass that fluctuates in size and has a tendency to become infected. In the case presented here, empiric antibiotics, ultrasonography, and referral to a specialist should be considered.
Benign Neck Disease
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Ricard Simo, Jean-Pierre Jeannon, Enyinnaya Ofo
Thyroglossal duct cysts are the most common upper neck midline lesion accounting for almost one-third of all congenital neck masses.24 They can present as a mass or lump, at any level between the foramen caecum and the upper mediastinum, with the majority presenting about the level of the hyoid bone. They are usually sporadic but a rare familial variant has been documented, identified as an autosomal dominant condition in pre-pubertal girls. Thyroglossal duct carcinoma, although rare, may present and be identified by the pathologist in a thyroglossal duct cyst.25, 26 This is described in the section on thyroid malignancies.
Thyroglossal duct cysts in children: a 30-year survey with emphasis on clinical presentation, surgical treatment, and outcome
Published in Acta Chirurgica Belgica, 2019
Tom Danau, Guy Verfaillie, Frans Gordts, Thomas Rose, Antoine De Backer
Thyroglossal duct cysts (TGDC) are one of the most common congenital midline deformities found in the anterior neck region in children [1]. Most of the patients are diagnosed before reaching the age of ten years [2], but TGDC can be diagnosed at any age. TGDC seem to strike both sexes almost equally [3] and appear to occur in 7% of the total population [4]. A TGDC finds its origin in the embryological development of the thyroid gland. When an embryo is 3 to 4 weeks old, a midline endodermal thickening in the primitive pharynx will occur. This thickening will evolve into a diverticulum, also known as the foramen cecum linguae. On its turn, this bilobed structure will protrude into the mesenchymal structure between the first two pharyngeal pouches. An epithelial fistula connects the foramen cecum linguae with the pharynx which is called the thyroglossal duct. During caudal projection, this duct will pass anteriorly from the mesodermal structures which will form the hyoid bone and will mount itself between the hyoid bone and the thyroid membrane. Within normal embryological development, this structure should obliterate around the tenth gestational week. However, during the descent of the duct, some epithelial structures may remain within the inferior border of the hyoid bone for unknown reasons, which can later cause the formation of a TGDC [5].
The efficacy of OK-432 sclerotherapy on thyroglossal duct cyst and the influence on a subsequent surgical procedure
Published in Acta Oto-Laryngologica, 2019
Tomoyasu Tachibana, Shin Kariya, Yorihisa Orita, Takuma Makino, Takenori Haruna, Yuko Matsuyama, Yasutoshi Komatsubara, Yuto Naoi, Michihiro Nakada, Yoji Wani, Soichiro Fushimi, Machiko Hotta, Katsuya Haruna, Tami Nagatani, Yasuharu Sato, Kazunori Nishizaki
OK-432 (Picibanil® Chugai Pharmaceutical Co., Tokyo, Japan) is a lyophilized streptococcal preparation made from the Su strain of A-group Streptococcus pyogenes incubated with penicillin [1,2]. This has been initially used as an immunotherapy agent for various malignant tumors [3]. The first line of treatment for benign non-thyroid cystic neck mass including thyroglossal duct cyst (TDC) is surgery [2]. Recently, OK-432 has also been applied to various otolaryngological cystic diseases, as a minimally invasive therapy [1,4]. Ohta et al. summarized the benefits of OK-432 therapy over the other surgical procedures as follows: (1) No hospitalization is required. (2) The treatment is painless and the time required for the procedure is brief. (3) No local anesthesia is required during the procedure. (4) Nerve injury and cosmetic problems are avoided. (5) Secondary infection and hemorrhage are rare. (6) Recurrences are less frequent [1,4].
Pediatric Bronchogenic Cysts: A Case Series of Six Patients Highlighting Diagnosis and Management
Published in Journal of Investigative Surgery, 2020
Jason E. Cohn, Kimberly Rethy, Rajeev Prasad, Judy Mae Pascasio, Katie Annunzio, Seth Zwillenberg
An 8-year-old female presented with a left thyroid mass after being diagnosed with Hashimoto’s thyroiditis. On physical exam, there was fullness of the left neck with a palpable, non-tender thyroid mass. The thyroid mass was cystic and measured at 5.4 cm × 4.3 cm × 3.0 cm on US. The mass was increasing in size, prompting a surgical evaluation. Laboratory testing revealed normal thyroid function testing (TSH, T3, and free T4) and positive thyroid peroxidase and thyroglobulin antibodies. The differential diagnosis for this patient included benign and malignant neoplasms of the thyroid gland as well as thyroglossal duct cyst.