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Thyroglossal duct papillary carcinoma is extremely rare in clinical practice.This article reports a case of a thyroglossal duct cyst complicated by thyroid papillary carcinoma,while also reviewing the relevant literature.It summarizes the clinical manifestations,imaging characteristics,and pathological features of thyroglossal duct papillary carcinoma and discusses the relationship between thyroglossal duct cysts,malignant transformation of thyroglossal duct cysts,and thyroid papillary carcinoma.

Objective: Intraoral thyroglossal duct cyst is a relatively rare clinical disease. This article reviews the diagnosis and treatment process of 7 patients and explores the clinical characteristics of diagnosis and treatment of intraoral thyroglossal duct cyst in combination with past literature reports., Method: A retrospective analysis was conducted on 7 cases of intraoral thyroglossal duct cyst admitted to the Otolaryngology ward of Dalian Municipal Central Hospital from January 2017 to January 2024. The cases were recorded in terms of gender, age, symptoms, physical signs, radiological examinations, surgical methods, and postoperative complications. All cases were followed up, and the latest follow-up results were recorded., Results: Among the 7 cases, 6 patients underwent laryngoscopic and radiological examinations before surgery, and 1 child was found to have a cyst during surgery. All cases were diagnosed with intraoral thyroglossal duct cyst and treated with plasma radiofrequency surgery. None of the patients had postoperative complications, and no recurrence was found in the six-month follow-up after discharge., Conclusion: Intraoral thyroglossal duct cyst is rare in clinical practice. It is important to pay attention to its differential diagnosis clinically, and careful review of images is required before surgery. Cryoablation with low-temperature plasma radiofrequency is not only minimally invasive and has a quick recovery but also has few complications and a low recurrence rate. It is a safe and effective treatment method that is worthy of clinical promotion., Level of Evidence: Level 3., (Copyright © 2024 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier España S.L.U. All rights reserved.)

Background: Thyroglossal Duct Cyst (TDC) is a common lesion of the midline neck, originating from an incomplete involution of the thyroglossal duct. It is typically observed in pre-scholar patients and surgery is the treatment of choice to prevent infections. Here reported a case of incidental diagnosis in a newborn patient., Case Presentation: a 3-week-old male baby was admitted to our hospital for weight loss and projectile vomits after breastfeeding. After a diagnosis of hypertrophic pyloric stenosis, the baby underwent pyloromyotomy. During the endotracheal tube placement, the anesthetist noticed the presence of a midline neck mass. The suspect of TDC was confirmed by an intraoperative ultrasound, so, despite the age of the patient, we proceeded with the excision of the lesion according to Sistrunk's procedure to avoid future complications and anesthesia., Conclusions: even if TDC is a common lesion of pediatric patients, anecdotical neonatal cases were described in the literature, all of them symptomatic. An accurate physical examination and ultrasound are essential diagnostic tools to distinguish TDC from other middle neck lesions, particularly ectopic thyroidal tissue. Sistrunk's procedure is the most effective surgical approach. When diagnosis is made in a newborn, we suggest postponing surgery, unless the baby requires general anesthesia for other surgical procedures, such as in our case., (© 2024. The Author(s).)

Thyroglossal duct cysts (TGDCs) are congenital and developmental abnormalities in infants and young children. This retrospective case series study examined the characteristics of 7 patients <3 years (mean age, 1.9 years) with TGDC complicated with a parapharyngeal mass treated at one hospital between January 2019 and 2022. Four patients had a painless mass around the neck, 2 had a painless mass associated with snoring, and 1 presented repeated swelling and pain. B-ultrasound suggested 6 cases of TGDC and 1 possible lymphangioma. All patients were treated with Sistrunk surgery to remove the TGDC. Six patients had no cyst recurrence during follow-up (6 months to 2 years). In conclusion, TGDC complicated with a parapharyngeal mass has complex and variable clinical manifestations. Completely removing the cyst while sparing thyroid cartilage and surrounding vascular and neuroanatomical structures is important to avoid complications. The patients are likely to be free from recurrence after surgery., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The clinicopathologic features of thyroglossal duct cyst when it develops ectopically in the thyroid gland remain unclear because of its rarity, which makes diagnosis difficult. Clinical diagnosis and treatment should not disregard the possibility of thyroglossal cysts located in the thyroid gland. We here report the current case to prepare others and provide data for the diagnosis and treatment of this kind of disease., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Abstract: Thyroglossal duct cyst is the most common congenital neck mass, but the incidence of malignancy within a thyroglossal duct cyst is rare, estimated at 1%. Most cancers arising within thyroglossal duct cysts are incidentally detected after surgical excision. We present the preoperative radiologic findings of 8 patients with papillary thyroid cancer arising within a thyroglossal duct cyst, as evaluated on ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography scan., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

This retrospective study aimed to investigate clinical diagnostic and management characteristics of double thyroglossal duct cyst (TDC) cases. Seventy-eight patients diagnosed with TDCs who were admitted to the inpatient ward of the Department of Otolaryngology, Dalian Central Municipal Hospital from June 2008 to October 2021 were included in the study. Ultimately, 67 of these patients were diagnosed with single TDCs and 11 patients with double TDCs. Each patient underwent computed tomography and color doppler ultrasound imaging of their neck masses, thyroid color doppler ultrasound imaging, and surgical cyst removal through the classic Sistrunk procedure. All surgically excised specimens were sent to the pathology lab for examination and were confirmed to contain TDCs. Two of the 67 patients with single TDCs experienced postoperative complications related to infections within the operative area, whereas no patients with double TDCs experienced postoperative infection, excessive bleeding, or other surgical complications. All cases were followed up for 1 to 3 years after surgery with no cyst recurrence observed. Double TDCs may present on physical examination as unilateral neck masses that interfere with tongue extension and movement and swallowing that can be identified using imaging methods. Correct clinical diagnosis and complete surgical removal of cysts are key measures for ensuring successful treatment outcomes for patients with TDCs., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Mutaz B. Habal, MD.)

A thyroglossal duct cyst (TGDC) is the result of incomplete degeneration of the thyroglossal duct during gestation. It is the most common type of congenital cyst of the neck, and is usually seen in children. The tumor mostly appears at the midline of the neck and generally causes no symptoms, but the mass typically moves when the patient swallows. We present the unusual case of a 50-year-old man with a large cervical mass lateralized on the right side of the neck. There was no association between swallowing and movement of the mass. Clinical examination and computed tomography (CT) suggested a lymphangioma or cystic hygroma. Surgical resection showed a large cyst of 71 x 40 x 52 mm with no attachment to the hyoid bone and no invasion in blood vessels or other surrounding tissue. Histopathological investigation led to a diagnosis of TGDC.

Introduction: Midline neck swellings are very common in children and mostly caused by thyroglossal duct cysts (TGDCs) or dermoid cysts (DCs). Since DCs can undergo simple excision, whilst TGDCs demand more thorough resection via Sistrunk procedure, it is important to differentiate between both pre-operatively. Previous studies have suggested an ultrasound-score (SIST) based on presence of septae, wall irregularity and solid components could do so. This study aims to evaluate the diagnostic accuracy of this score., Methods: All patients (≤18 years) undergoing surgery between 2006 and 2018 for a midline neck mass at our tertiary centre with a histopathological diagnosis of TGDC or DC were retrospectively included. The pre-operative ultrasound was evaluated by an experienced radiologist and the SIST as well as location, tract, echogenicity, margin and multilocularity were scored., Results: We included 97 children, of whom 67 (69 %) with TGDCs. The SIST showed a sensitivity of 37 %, specificity of 97 %, a positive predictive value of 96 % and a negative predictive value of 35 % for the SIST-score in detecting TGDCs, which resulted in an AUC of 0.67. In addition, internal echogenicity (P < 0.01) and margin definition (P < 0.01) were significantly associated to TGDC diagnosis whilst location and multilocularity were deemed insignificant following Bonferroni correction., Conclusion: We conclude that the SIST-score seems very capable to rule in TGDC. However, the SIST-score is far from making a clear distinction between DC and TGDCs preoperatively. The addition of other ultrasound variables, such as margin definition and echogenicity, might increase the diagnostic accuracy and demands further research., Competing Interests: Declaration of competing interest We declare that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome., (Copyright © 2023. Published by Elsevier Inc.)

Objective: To validate and compare novel ultrasound scoring systems for dermoid cysts and thyroglossal duct cysts among pediatric patients., Study Design: Retrospective study., Setting: Tertiary care children's hospital., Methods: An electronic medical record query of patients younger than 18 years old who underwent primary excision of a neck mass between January 2005 and February 2022, who underwent preoperative ultrasound, and had final histopathologic diagnosis of either thyroglossal duct cysts or dermoid cysts. This generated 260 results, of which 134 patients met the inclusion criteria. Charts were reviewed for demographic data, clinical impressions, and radiographic studies. Radiologists blindly reviewed ultrasound for SIST score (septae + irregular walls + solid components = thyroglossal), and 4S algorithm (Septations, depth relative to Strap muscles, Shape, Solid parts). Statistical analyses were performed to determine the accuracy of each diagnostic modality., Results: Of 134 patients, 90 (67%) had a final histopathologic diagnosis of thyroglossal duct cysts, and 44 (33%) were dermoid cysts. The accuracy of clinical diagnosis was 52%, and preoperative ultrasound report accuracy was 31%. The 4S and SIST accuracies were each 84%., Conclusion: Both the 4S algorithm and SIST score provide increased accuracy of diagnosis relative to standard preoperative ultrasound assessment. Neither scoring modality was determined to be superior. Further research is warranted in improving the accuracy of preoperative assessments for pediatric congenital neck masses., (© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)

Objective: To discuss our institutional experience with endoscopic management of intralingual thyroglossal duct cyst (TGDC) and review cases in the published literature in a systematic review., Methods: Pediatric patients with intralingual TGDC treated with endoscopic surgery at our institution from 2009-2019 were identified. Metrics from our case series were then compared to those in the literature in a systematic review to assess pooled outcomes of endoscopic or transoral management. Patient demographics, age of presentation, presenting symptomatology, size of cyst on imaging, type of surgery, and post-operative outcomes were assessed., Results: We identified 5 institutional cases of intralingual TGDC and 48 cases of intralingual TGDC described in the literature. The average age of presentation was 20.36 months. 69.8% (N=37) of patients presented with at least one respiratory symptom, 22.6% (N=12) presented with dysphagia, 9.4% (N=5) presented with an identified mass in the oropharynx, and 15.1% (N=8) had the cyst discovered as an incidental finding. Three patients required revision surgeries due to prior incomplete TGDC excisions and one patient experienced a recurrence >6 months after primary excision requiring a second procedure. Our data pooled with published case series in systematic review confirms that endoscopic or transoral management are excellent options for definitive management of intralingual TGDC., Conclusions: Intralingual TDGC is a potentially life-threatening variant of TGDC. Our results pooled with published series in a systematic review suggest that endoscopic or transoral management of intralingual TGDC are excellent minimally invasive treatments with a low risk of recurrence. Postoperative surveillance up to one year is recommended., Competing Interests: Declaration of Competing Interest The authors have no financial support or conflicts of interest to declare., (Copyright © 2022. Published by Elsevier B.V.)

Objective: To provide reference for preoperative diagnosis and treatment of thyroglossal duct cyst by studying the morphological changes of hyoid body. Methods: The CT data（midsagittal image） of congenital thyroglossal duct cyst（TGDC group） diagnosed by pathology and the control group（C group） were collected from January 2016 to October 2021. The differences of hyoid body height（HBH）, hyoid body width（HBW）, hyoid bone thickness（HBT）, HBW/HBH, HBT/HBH between the two groups were compared. HBH, HBW and HBT were analyzed by t -test; The HBW/HBH and HBT/HBH were analyzed by Mann-Whitney U test. Results: Twenty-nine cases were included in the TGDC group and 58 in the C group. The HBH in the TGDC group was（8.93 ±0.22） mm and that in the C group was（8.94±0.12） mm, there was no significant difference between the two groups（ P >0.05）. The HBW in the TGDC group and the C group were（5.09±0.21） mm and（4.48±0.11） mm, and the HBT were（3.84±0.12） mm and（3.13±0.08） mm, respectively, the difference between the two groups was statistically significant（ P <0.05）. The average rank sum of HBW/HBH in the TGDC group and the C group was 53.95 and 39.03, respectively, and the average rank sum of HBT/HBH was 59.90 and 36.05, respectively, the difference between the two groups was statistically significant（ P <0.05）. Conclusion: The morphological changes of hyoid body of thyroglossal duct cyst may be helpful for preoperative diagnosis, and it also suggests that hyoid body resection may reduce the possibility of postoperative recurrence., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

The unobliterated portion of embryological thyroglossal duct may present as cystic swelling later in life and may contain functional thyroid follicles. This cyst requires excision along with the entire thyroglossal duct remnant and adjacent portion of hyoid bone. At times, the excised specimen could demonstrate a focus of carcinomatous change inside the cyst wall. Very rarely, this thyroglossal duct cyst carcinoma could be associated with malignancy of native thyroid gland. This case report illustrates an interesting case of synchronous carcinoma of thyroglossal duct cyst and native thyroid gland. It also sheds light on the controversies related to the pathophysiology of such association and the dilemmas surrounding the management of thyroglossal duct cyst carcinoma, with or without concurrent carcinoma of thyroid gland., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

A clinical case of ectopic thyroid carcinoma in front of hyoid bone was reported in this paper. The patient, a 17-year-old female, presented with an enlarging neck mass of 1-week history. Physical examination revealed a 3 cm×2 cm neck mass in front of the hyoid bone. Ultrasonographic depicted as a cystic solid mixed echogenic mass with punctate strong echogenicity. CT scan showed a cystic-solid mass in front of the hyoid bone with punctate calcifications. The patient was misdiagnosed as a thyroglossal duct cyst and underwent surgery. The final pathological diagnosis was papillary thyroid carcinoma with cyst formation., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objectives: Lingual thyroglossal duct cysts (LTGDCs) are clinically rare and easily misdiagnosed as epiglottic cysts. Misdiagnosis leads to mistreatment; thus,simple diagnosis is important. This study aimed to investigate the characteristics of LTGDCs with flexible laryngoscopy and imaging, improve their diagnosis and explore surgical methods for patients undergoing an initial operation and patients with recurrence., Methods: In total, 10 patients with LTGDCs were admitted from April 2014 to December 2020.By reviewing the diagnosis and treatment of the first typical case, the characteristics of LTGDC under flexible laryngoscopy were summarized. According to these characteristic manifestations, a clinical diagnosis of LTGDC was made correctly in the other 9 patients. All 10 patients underwent preoperative CT of the neck and sagittal reconstruction and thyroid ultrasound., Results: Of the 10 patients, the first 2 patients had recurrent LTGDCs after several operations and underwent Sistrunk surgery. The remaining 8 patients were newly diagnosed and underwent endoscopic radical resection with low-temperature coblation; of these patients, 7 had no recurrence, and 1 underwent Sistrunk surgery after developing short-term recurrence. All patients were followed up for 5 months to 6 years after the last operation and were without recurrence., Conclusion: LTGDCs are easily misdiagnosed as epiglottic cysts in the clinic. A correct clinical diagnosis can be made based on the characteristics according to flexible laryngoscopy. To determine the relationship between the cyst and hyoid bone, CT was performed. The surgical method was chosen based on the relationship between the cyst and hyoid bone and history of recurrence., (Copyright © 2022 Elsevier Inc. All rights reserved.)

This article presents a case of an epidermoid cyst that mimicked a thyroglossal duct cyst in a pediatric patient. An 8-year-old boy was referred for evaluation of a volumetric increase in the median cervical region with an evolution of about 4 years. The skin in the submental region was healthy and normal colored. Palpation revealed a mobile, well-circumscribed nodular lesion of soft consistency. Computed tomography of the neck showed an expansive hypodense formation extending from the base of the tongue to the upper portion of the hyoid bone, suggesting a thyroglossal duct cyst. Considering the diagnostic hypothesis, cystic enucleation via the Sistrunk procedure was planned. However, no ductal structure was identified during the surgical procedure, and the lesion was only near, but not attached to, the hyoid bone. Simple excision of the lesion was therefore performed. At the most recent follow-up examination, about 3 months postoperatively, the patient demonstrated satisfactory clinical progress. The epidermoid cyst close to the hyoid bone presented diagnostic difficulty due to its similarity to a thyroglossal duct cyst. Computed tomography provides limited information for diagnosing this type of lesion, and ultrasonography is the preferred test. In view of the uncertain diagnosis in this case, the extent of the excision was determined during the surgery, and simple excision was a satisfactory treatment associated with a good prognosis., Competing Interests: The authors report no conflict of interest pertaining to any of the topics discussed in this article.

Background: Thyroglossal duct cysts (TGDCs) are the most common congenital midline cystic lesions in the neck, and they are often evaluated by fine-needle aspiration. Recognizing the cytomorphologic features of TGDCs and their mimics is important for clinical management., Methods: This study examined the clinical, radiological, and cytopathological features of 86 ultrasonography-guided fine-needle aspiration (US-FNA) specimens from clinically suspected TGDCs or malignancies arising from TGDCs and correlated the findings with surgical follow-up and/or imaging studies., Results: According to ultrasound examinations of 66 lesions, 17 (25.8%) were cystic, 8 (12.1%) were cystic with septations, 21 (31.8%) were cystic with solid nodules, and 20 (30.3%) were solid or cystic with internal debris. Cytopathologically, 81 lesions (94%) were categorized as benign, 2 (2%) were categorized as atypical, and 3 (3%) were categorized as malignant. In benign lesions, proteinaceous material (63%), histiocytes (63%), colloid (37%), squamous cells (35%), columnar cells (32%), follicular cells (15%), inflammatory cells (9%), and multinucleated giant cells (9%) were noted. Diagnoses in the benign category included TGDC in 64 patients (75%), TGDC or mimics (colloid nodule/epidermoid cyst) in 14 patients (17%), a colloid nodule in 1 patient, and thyroiditis in 1 patient. Surgical resection, performed in 23 patients, confirmed TGDCs in 12, benign mimics in 7, and carcinoma in 4., Conclusions: Cytopathological features, in conjunction with imaging, allowed a definite diagnosis of TGDC in most patients (75%). The presence of mature squamous cells, thyroid follicular cells, with or without colloid and/or lymphocytes alone allowed a differential diagnosis of TGDC and its mimics in 17%. US-FNA findings could not distinguish primary carcinomas arising from TGDCs from metastatic tumors., (© 2021 American Cancer Society.)

Purpose: The purpose of this study was to evaluate thyroglossal duct cyst (TGDC) volumes before and after treatment with ultrasound (US) in patients who underwent ethanol ablation (EA). Besides, the usability of cosmetic scoring in TGDC cases was investigated by comparing cosmetic scores pre-treatment and after EA., Materials and Methods: 28 TGDC cases who had EA in one session and had complete US data and cosmetic scores were included in the study. US data including TGDC diameters and volumes obtained at the pre-treatment, 3rd, 6th, and 12th month after EA were noted, respectively. Cosmetic scoring was performed pre-treatment and after EA using the WHO grading system simultaneously with US., Results: At the 12th month after EA, there was 85.2% reduction in mean diameter and 95.1% reduction in mean volume in TGDC cases (p < 0.001). The mean cosmetic score pre-treatment was 2.7 ± 0.8 and the mean cosmetic score at the 12th month was 1 (p < 0.001). When the changes in TGDC volumes and cosmetic scoring after EA were compared according to gender and age, there was no statistically significant difference (p > 0.05)., Conclusion: The current study demonstrated that EA can be used safely to reduce TGDC sizes and is an alternative treatment option to surgery., (© 2021. Japan Radiological Society.)

Introduction: Lingual thyroglossal duct cysts (LTGDC) are a rare kind of thyroglossal duct cyst. However, Sistrunk surgery is not very suitable for this type of cyst. This study aimed to explore the efficacy of transoral excision of LTGDC by plasma coblation., Methods: The present study reviewed 11 patients, comprising seven males and four females, who had been diagnosed with LTGDC preoperatively by computed tomography (CT) and fibre-optic electronic laryngoscopy. Of those patients, two had recurrence after surgery of epiglottic cysts. All these patients underwent transoral excision by plasma coblation. Then, we collected preoperative data of the patients, observed the effect of surgery, and analysed factors relevant to LTGDC, including the estimated bleeding amount, postoperative hospitalisation, complications and recurrence rates., Results: The connection between LTGDC and hyoid was tapered on sagittal images of CT, which was vital evidence for the diagnosis of LTGDC. Surgery was performed successfully for all 11 patients, and all recovered without complication. There was no evidence of recurrence after surgery, during follow up for 3-43 months., Conclusions: Transoral surgery for LTGDC can be performed successfully by plasma coblation, which is an effective and safe surgical treatment. Fibre-optic electronic laryngoscopy and CT are essential to the diagnosis of LTGDC in order to avoid missing detection and misdiagnosis.

We report an unusual case of synchronous papillary carcinoma of thyroglossal duct cyst (TGDC) and thyroid gland. Here, the radiology findings, surgical approach and subsequent management, and pathology of an synchronous papillary carcinoma of TGDC and thyroid gland are described., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Thyroglossal duct cyst (TGDC) is a congenital neck malformation, with a rate of approximately 7% in paediatric patients. TGDC is rarely detected in infants aged younger than 1 year. Even though TGDC is histologically benign, it is associated with preterm delivery or sudden infant death due to airway obstruction, with a mortality rate of 30% to 40%. We report a rare case of a neonate who presented with a large left lateral neck mass. At 7 to 8 months of gestation, magnetic resonance imaging of the foetal neck showed that there was a high possibility of a cervical cystic lymphangioma. The patient had normal vital signs and was afebrile. She was immediately transferred to our Ear, Nose, and Throat Department for further diagnosis and treatment. A computed tomography scan confirmed a large cystic mass that was positioned against a thyroglossal duct. Excision of the mass in the left neck was performed under general anaesthesia without resecting part of the hyoid bone. A histopathological examination confirmed the diagnosis of a TGDC. Follow-up at 1 year showed no recurrence.

Objective: 1) To assess reproducibility of the previously established SIST score. 2) To determine inter-observer agreement in using ultrasound (US) characteristics to differentiate thyroglossal duct cyst (TGDC) from dermoid cysts (DC) 3) Improve the method used to pre-operatively differentiate TGDC from DC., Study Design: Retrospective chart review., Setting: Tertiary care pediatric hospital. SUBJECTS AND METHODS: An electronic medical record was queried to identify children with midline neck masses who underwent pre-operative neck US and had a histopathologic diagnosis of either TGDC or DC. Two pediatric radiologists, blinded to the pathologic diagnosis, evaluated the US images and documented the presence of pre-determined characteristics of each mass. Potential differentiating factors were analyzed for their predictive power. The SIST (septations, irregular walls, solid components = TGDC) score was determined as well as inter-observer agreement. Using the characteristics that had significant predictive power, we used the data to develop an algorithm to improve predicting cyst type., Results: Pathologically, there were 47 TGDC and 25 DC. The inter-observer agreement about the pathologic diagnosis between the two radiologists was substantial, K = 0.66. Overall, the SIST score predicted the correct diagnosis 67% of the time. Radiologist 1 and radiologist 2 were more accurate than the SIST score alone, making the correct diagnosis 96% and 86% of the time, respectively. In our study, we found that the most important US characteristics in differentiating TGDC and DC are: internal Septations, depth relative to Strap muscles, Shape and Solid parts (4 S algorithm). The SIST score criteria were individually shown to be significant and sensitive in recognizing DC, however, they were not specific and often misclassified TGDC as DC. We developed a new sequential filtering algorithm that more accurately differentiates cysts. This new algorithm uses step-wise filtering of characteristics, first for Septations, then for depth to Straps, then Shape of the cyst and lastly Solid parts (4 S algorithm). This algorithm correctly categorized cyst type in 100% of patients in our study., Conclusions: Pre-operatively differentiating TGDC and DC continues to be a challenge. Using our 4 S algorithm, we can more definitively differentiate TGDC from DC compared to the SIST score. All SIST score characteristics were significant and sensitive in detecting dermoid cysts, however, not very specific. The radiologists' judgment and accuracy was better than the SIST score. The 4 S algorithm uses sequential filtering of important characteristics: Septations, depth to Straps, Shape of cyst and lastly Solid parts to improve diagnostic accuracy., (Copyright © 2021. Published by Elsevier B.V.)

Objective: Thyroglossal duct cysts (TGDCs) are relatively common congenital midline neck masses that are treated with surgical excision. Traditionally these are removed along with any associated tract and the central portion of the hyoid bone through an anterior neck incision. Some patients with TGDCs want to avoid an external neck scar., Methods: We describe the details of a transoral endoscopic vestibular excision of a TGDC and the associated hyoid bone in an adolescent patient., Results: This novel approach was successful and there were no complications., Conclusion: We propose that cervical TGDCs can be safely and completely removed with this approach in appropriately selected patients while avoiding a neck scar.

Carcinoma arising in a thyroglossal cyst is rare. We present a case of anterior neck swelling diagnosed to be thyroglossal cyst clinically which turns out to be a papillary carcinoma arising in thyroglossal cyst. She underwent sistrunk procedure with total thyroidectomy and diseasefree on follow up evaluation. Even though preoperative ultrasonography had shown thyroid nodule, the final histology did not show malignancy. There is a paucity of clear-cut guidelines in the management of the thyroid gland in a thyroglossal cyst carcinoma. In thyroglossal cyst carcinoma cases, we recommend thyroidectomy only when there is a thyroid nodule with high-risk features.

Thyroglossal duct cysts (TGDCs) are the most common congenital abnormality of the neck, accounting for approximately 70% of congenital neck lesions. Two-thirds of thyroglossal duct anomalies are diagnosed within the first three decades of life, with more than half being identified before 10 years of age. The age of presentation, clinical examination and imaging are essential for an accurate diagnosis. This review aims to summarize the imaging findings of TGDCs and their main differential diagnoses with emphasis on ultrasound assessment. A focus on site-specific key differentiating between them is also addressed.

Objective: Thyroglossal duct cysts are the most common congenital neck mass. They typically present as a painless midline neck mass in a child or young adult, but may also present later in adulthood when the cyst becomes symptomatic. Thyroglossal duct cysts are most commonly located inferior to the hyoid bone in close relation with the thyrohyoid membrane. Very rarely, they may extend intralaryngeal, occupy the posterior hyoid space, and present with dysphonia and/or dysphagia. To our knowledge, this is the 24th reported case in the literature., Methods: Case report with a comprehensive review of the literature., Results: The patient was a 43-year-old male experiencing dysphonia and dysphagia following a motor vehicle accident. He was subsequently found to have a large thyroglossal duct cyst with endolaryngeal extension that was previously asymptomatic and undiagnosed. He underwent successful surgical excision which resulted in resolution of symptoms., Conclusion: This is the first reported case of a thyroglossal duct cyst in the posterior hyoid space with endolaryngeal extension being diagnosed following a traumatic event. This case illustrates the need to consider thyroglossal duct cyst in the differential diagnosis when working up a post-traumatic intralaryngeal neck mass. A secondary educational objective in this case is to be diligent to consider and rule out laryngeal fracture in the case of a neck mass presenting after trauma as they can easily be missed and present with many overlapping symptoms.

BACKGROUND Thyroglossal duct cysts are the most common congenital neck cysts. They typically present in childhood and early adulthood, and average a size of 2-4 cm, but can also present in later adult life. CASE REPORT We present a case of a 36-year-old female patient with a very large midline neck mass, reaching the mandible superiorly. Patient history and physical examination, as well as computed tomography scan of her neck, confirmed the diagnosis of large thyroglossal duct cyst. She underwent Sistrunk procedure for thyroglossal duct cyst excision, and the specimen was sent for histopathological evaluation, which confirmed the diagnosis. CONCLUSIONS Thyroglossal duct cyst should be considered as a differential diagnosis in older patients and in patients with a relatively large neck mass.

Objective: Evaluate ultrasound (US) sensitivity and specificity in suspected thyroglossal duct cysts (TGDC) undergoing surgery in our hospital, and their correlation with surgical findings., Material and Methods: Retrospective study of 150 patients undergoing surgery for midline neck mass suggestive of TGDC (2008-2018). We analyzed epidemiological variables and compared the correlation between diagnostic ultrasound imaging and surgical findings, considering previous episodes of local infection., Results: Mean age at surgery was 3.96 years (0.75-12.58 years). Of the 150 patients, 81 were male and 69 were female. Following ultrasound examination, 110 were suspected to have TGDC, and diagnosis was confirmed after surgery in 80 cases. Of the remaining 40 cases without TGDC-compatible US examination, TGDC was confirmed in 15 cases. The rest were diagnosed with dermoid cyst (49), lymphadenopathy (4), and vascular malformation (2). US sensitivity was 84%, while specificity was 45%, with a positive predictive value of 73%, and a negative predictive value of 62%. In 62.1% (59) of TGDCs, a previous infection episode had been described, with 16.7% of cases requiring surgical drainage. 13.6% had recurrence after Sistrunk technique. There was no statistically significant relationship between previous infection episodes and postsurgical recurrence, or between surgical or spontaneous drainage and cyst recurrence., Conclusions: Even though US role in eutopic thyroid gland identification cannot be doubted, it provides with low specificity in the study of midline neck masses. Therefore, the physician's opinion should be prioritized.

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BACKGROUND This study aimed to evaluate the prevalence of thyroglossal duct cysts (TGDCs) on ultrasonography (US) and US features of TGDCs in adults, and to assess whether the prevalence or size of TGDCs increases after radioactive iodine ablation (RIA). MATERIAL AND METHODS Between July and December 2018, 2820 patients underwent thyroid or neck US examination, performed by 2 radiologists, at our center. On the basis of real-time US, the presence or absence of TGDCs was prospectively investigated by 2 radiologists. Among the 2820 patients, 54 patients who were <19 years of age or had a radiation therapy history to the neck were excluded. Eventually, 2766 patients were included. RESULTS Of the 2766 patients, 160 (5.8%) showed a TGDC on US. The mean size of TGDCs in RIA history (+) (n=36) and RIA history (-) (n=124) groups was 0.92±0.41 cm and 0.86±0.45 cm, respectively. There was no significant difference in size of TGDCs between RIA history (+) and RIA history (-) groups (p=0.684). Between the TGDC (+) and TGDC (-) groups, there was no significant difference in patient age, gender, reason for thyroid/neck US, type of thyroid surgery, and session number and application/no application of RIA (p>0.05). The prevalence rate of TGDCs in radiologist A and B was 4.9% (70/1427) and 6.7% (90/1339), respectively. TGDCs were more common in the suprahyoid neck, and the common shapes of TGDCs were flat-to-ovoid and round. CONCLUSIONS RIA may not be associated with the prevalence or enlargement of TGDCs.

Purpose: to differentiate sublingual thyroglossal duct cyst (TGDC) from midline dermoid cyst (DC) with diffusion weighted imaging (DWI)., Materials and Methods: Retrospective analysis of 22 consecutive patients (11 male and 11 female aged 5-15 years) with midline cystic lesion at floor of mouth. They underwent DWI of floor of mouth. Apparent diffusion coefficient (ADC) of the cystic lesions was calculated and correlated with surgical findings., Results: The mean ADC value of TGDC of 1st observer was (2.20 ± 0.28 × 10 -3  mm 2 /s) and of 2nd observer was (2.28 ± 0.27 × 10 -3  mm 2 /s) was significantly higher than that of DC (P = 0.001) whose ADC of 1st observer was (1.55 ± 0.15 × 10 -3  mm 2 /s) and of 2nd observer was (1.53 ± 0.11 × 10 -3  mm 2 /s). There was excellent inter-observer agreement of both readings (r = 92%, P = 0.001). When ADC of 1.76 and 1.62 × 10 -3  mm 2 /s was used as a threshold value for differentiating TGDC from DC, the best results were obtained with area under the curve of 0.94 and 0.96, accuracy of 90% and 86%, sensitivity of 91% and 91%%, specificity of 90% and 80%, negative predictive value of 90% and 88% and positive predictive value of 92% and 84% of both reviewers respectively., Conclusion: DWI is reliable and reproducible imaging modality for differentiation sublingual TGDC from DC., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Although there are studies regarding the efficacy of OK-432 sclerotherapy on thyroglossal duct cyst (TDC), its effects on surgical procedure following this therapy have not been properly described. Objectives: The present study aimed to delineate the prognostic factors of OK-432 sclerotherapy in patients with TDC and investigate its influence on subsequent surgical procedure and the histological characteristics in patients with poor response to OK-432 sclerotherapy. Material and methods: We conducted a retrospective analysis of the medical records of 20 TDC patients treated with OK-432 sclerotherapy. Results: Of the 20 patients, OK-432 sclerotherapy was effective in 5 patients (25.0%). OK-432 showed a lower effective rate in multilocular cysts (9.1%) than in unilocular cysts (44.4%), although not significantly. Five cases were treated with surgery following OK-432 sclerotherapy. There was no significant difference in the operating time and the amount of bleeding between patients with and without OK-432 sclerotherapy. From the results of the histological examination of the cyst wall, two cases had stratified squamous epithelium and two cases showed the absence of lymphocyte infiltration. Conclusion and significance: OK-432 sclerotherapy is an acceptable initial treatment for TDC, especially in unilocular cysts, because of lack of influence on surgical procedure.

Objectives: To evaluate the use of ultrasound to distinguish between thyroglossal duct cysts (TGDC) and dermoid cysts (DC) for surgical planning. To validate the SIST (septae + irregular wall + solid components = TGDC) scoring system proposed by Oyewumi et al. [1]., Methods: This was a retrospective chart review of pediatric patients with midline neck masses who presented between the years of 2005 and 2014 and underwent preoperative ultrasound and surgical resection. Two pediatric radiologists blinded to diagnosis reviewed each US for 14 separate characteristics. According to the SIST scoring system, one point was given for each of the following: internal septae, irregular walls, and solid components., Results: 45 patients met inclusion criteria. Final pathologic diagnosis showed 29 patients had TGDC, 16 had DC. The majority of patients with both TGDC and DC earned SIST scores of 0., Conclusion: While ultrasound remains a useful part of the work-up of lesions of the head and neck in children, this small retrospective study was not able to validate the previously proposed SIST scoring system None of the parameters discussed in the original paper was found to be a statistically significant determinant of TGDC., (Copyright © 2019. Published by Elsevier B.V.)

Objective: 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., Study Design: Retrospective chart review., Setting: Tertiary care children's hospital., Subjects: 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., Methods: 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., Results: 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., Conclusion: 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.

A thyroglossal duct cyst (TGDC) is a common embryological remnant that typically presents as an anterior neck mass; however, this malformation can occur in any adjacent area, including the tongue base (lingual type), along the migration path of the thyroid during embryonic development. Lingual TGDC is often quiescent until infection occurs. Supraglottitis or inflammation of the supraglottis, is a potentially life-threatening disease. Because of the anatomical proximity of lingual TGDC to the supraglottis, lingual TGDC infection might be related to a presentation of supraglottitis. A 49-year-old male initially presented with clinical symptoms of acute supraglottitis. After intensive medical treatment resulting in no improvement, a computed tomography scan was performed. The result raised the suspicion of an infected lingual TGDC. Transoral marsupialization using a rigid laryngoscope was performed to drain the abscess inside the cyst. A diagnosis of lingual TGDC was made based on the characteristic histological pattern of the lesion. After treatment, a follow-up computed tomography scan showed no evidence of recurrence. To the authors' knowledge, only a few reports have pointed out similarities in the clinical and radiological findings between acute supraglottitis and an infected lingual TGDC. Clinicians should consider lingual TGDC during the differential diagnosis of supraglottitis, especially in patients with poor response to medical treatment.

Thyroglossal duct cysts (TDCs) are the most common congenital midline neck masses. Lingual TDC is a rare variant that emerges as an isolated cyst at the tongue base. Unlike conventional procedures aiming removal of cyst, duct, and hyoid bone via open surgical access, a transoral cystectomy is mostly sufficient in cases with lingual TDC. We present a case describing a 3-month-old infant patient with lingual TDC who was successfully treated with transoral robotic surgery. The cyst wall was completely excised with no complications or obvious bleeding occurred. The operating time was 10 min. He had an uneventful postoperative course. Six months postoperatively, he is free of symptoms with no evidence of recurrence. Surgical treatment of lingual TDC in an infant is possible with transoral robotic approach and minimal risk of complication. Further studies are strongly needed to confirm the safety of robotic surgery in pediatric population.

Thyroglossal duct cyst is a common congenital cyst in the neck. The incidence of primary carcinoma of the thyroglossal duct is less than 1% in all age groups. We present the case of a 63-year-old man with rapid expansion of a known thyroglossal duct cyst with mixed solid/cystic components. F-FDG PET/CT showed a large anterior neck mass with a non-FDG-avid cystic component and a hypermetabolic heterogeneous mass on the right side confirmed by histopathology to be squamous cell carcinoma. Although rare, F-FDG PET/CT can assist with evaluating the extent of malignant involvement in thyroglossal duct cyst squamous cell carcinoma.

Cervical congenital malformations are relatively common in children. They can also be found in adults. The embryological development of the cervical region is closely related to the branchial clefts. This must be a diagnosis made by elimination; a cervical tumor must evoke the diagnosis of cancer. A cutaneous fistula or a cervical tumor, chronic or recent appearance in an inflammatory context, are the clinical signs. The thyroglossal duct cysts and the second branchial clefts cysts are the most common causes of median and lateral cervical cysts, respectively. Imaging contributes greatly to the orientation and diagnostic evaluation of the extent of the lesions. Treatment is initially based on antibiotic therapy and then on complete surgical excision, away from an infectious episode, the sole guarantee for the absence of local recurrence., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Congenital neck masses can be a developmental anomaly of cystic, solid, or vascular origin. They can also constitute neoplasms, including malignancies, although this is rare in the pediatric population. The history and examination can help quickly narrow the differential diagnosis. Imaging also plays an essential role in defining the characteristics and likely cause of neck masses. The most common neck masses in young children are thyroglossal duct cysts, branchial cleft anomalies, and dermoid cysts. Also important to consider in the differential diagnosis are solid tumors, such as teratomas, or vascular lesions, such as hemangiomas., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background and Purpose: There has been no previous study that used ultrasonography for longitudinal changes of thyroglossal duct cysts, to our knowledge. We assessed the prevalence and interval changes in incidentally detected thyroglossal duct cysts in adults., Materials and Methods: From January 2010 to December 2016, we identified 796 ultrasonography radiologic reports from 513 subjects that contained the words "thyroglossal" or "TGDC" among 54,369 participants. Of 513 subjects, 172 (M/F = 103:69, mean age, 53 ± 11 years) who underwent ≥2 sonography studies were enrolled. Two reviewers determined ultrasonography features, including maximal diameter, location, internal echogenicity, wall thickness, and the presence of posterior enhancement, internal septa, and solid components., Results: The mean follow-up time of total 172 lesions was 2.01 ± 1.13 years. Thyroglossal duct cysts ranged from 2 to 32 mm (mean, 8.77 ± 3.83 mm) on the initial ultrasonography examination. On follow-up ultrasonography studies, 14 lesions (8.2%) increased by >2 mm, while most thyroglossal duct cysts (133 lesions, 77.3%) remained stable in size. During the follow-up period, 31 lesions (18.0%) showed interval changes in ultrasonography features. There was no significant relationship between the presence of ultrasonography feature changes and size changes ( P = .12)., Conclusions: On ultrasonography, 0.9% of adults had incidental thyroglossal duct cysts. Most did not increase in size with time despite changes in various ultrasonography features. Therefore, we recommend performing an observation at long intervals of 2-3 years for asymptomatic thyroglossal duct cysts, and we suggest that fine-needle aspiration can be suspended unless suspicious findings of malignancy are detected., (© 2018 by American Journal of Neuroradiology.)

Ultrasonography (US) of the neck is an accepted, useful imaging modality for many applications beyond its usefulness in thyroid disease. Two-dimensional US has been effectively used for evaluation of many types of neck conditions, and now, 3-dimensional US can be added to the imaging armamentaria. Three-dimensional US is useful in the evaluation of cervical lymph nodes, recurrent/residual thyroid neoplasia, parathyroid glands, parotid and submandibular glands, as well as thyroglossal duct cysts and other assorted palpable and visible abnormalities because of its unique capabilities, including multiplanar reconstruction, accessibility of the coronal view, volume calculation, and regularly spaced incremental slice evaluation., (© 2017 by the American Institute of Ultrasound in Medicine.)

Lingual thyroglossal duct cysts are a rare and potentially difficult to manage tongue base lesion. We report a case of transoral robotic surgical excision of a lingual thyroglossal duct cyst, in an adult patient. A 68-year-old man presented with a large base of tongue mass, with appearance on ultrasound and computed tomography consistent with a lingual thyroglossal duct cyst. We describe the surgical technique for transoral robotic excision of the cyst. The cyst was completely excised, and the patient had a smooth recovery. There has been no recurrence of the cyst. Transoral robotic surgery has several advantages over the conventional surgical approaches in the treatment of lingual thyroglossal duct cysts, including superior visualisation, and the ability of the robotic surgical system to manoeuvre instruments in a confined space. This enables complete excision, preventing recurrence of the cyst whilst also avoiding a neck scar.