Thyroglossal Cyst

甲状舌管囊肿
  • 文章类型: Journal Article
    目的:口状舌管囊肿是临床上较为少见的疾病。本文对7例患者的诊治过程进行综述,结合以往文献报道,探讨口内甲状舌管囊肿的临床诊治特点。
    方法:对2017年1月至2024年1月大连市中心医院耳鼻咽喉科收治的7例口内甲状舌管囊肿进行回顾性分析。这些病例是按性别记录的,年龄,症状,身体体征,放射学检查,手术方法,术后并发症。所有病例均得到随访,并记录最新的随访结果。
    结果:在7例中,6例患者在手术前接受了喉镜和放射学检查,1名儿童在手术中被发现有囊肿。所有病例均诊断为口内甲状舌管囊肿,并采用等离子射频手术治疗。患者均无术后并发症,出院后6个月随访未见复发。
    结论:口状甲状舌管囊肿临床少见。临床上重视其鉴别诊断,手术前需要仔细检查图像。低温等离子射频冷冻消融术不仅创伤小,恢复快,而且并发症少,复发率低。是一种安全有效的治疗方法,值得临床推广。
    方法:第3级。
    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.
    METHODS: 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.
    CONCLUSIONS: 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.
    METHODS: Level 3.
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  • 文章类型: Journal Article
    背景:甲状舌管癌,一种罕见的临床疾病,特征是甲状舌管囊肿(TGDC)中的异位甲状腺腺癌,通常通过术中快速病理证实,这种情况通常预后良好。然而,缺乏所有疾病阶段的综合治疗指南,本研究的目的是报告1例该病,并提出该疾病各阶段的治疗方案。
    方法:一名患者表现为甲状腺肿胀,在体检后被分类为C-TIRADS4A。术前甲状腺穿刺发现甲状腺乳头状癌,基因检测显示BRAF基因外显子15点突变。辅助测试显示促甲状腺激素(TSH)水平略有下降(0.172),无其他明显异常。
    方法:术前细针穿刺细胞学检查(FNAC)证实右侧甲状腺癌。术中探查发现TGDC,术中快速病理证实甲状舌管癌。
    方法:进行Sistrunk手术和同侧甲状腺切除术。
    结果:术后恢复令人满意。
    结论:甲状舌管癌是一种罕见的颈部病变。由于有限的临床病例和与这种情况相关的良好预后,目前尚无既定的诊断和治疗指南.根据肿瘤大小,淋巴结转移,甲状腺状态和其他因素,针对甲状舌管癌的各个阶段建立了相应的治疗方法,为该疾病的后续治疗发展奠定了基础。
    BACKGROUND: Thyroglossal duct carcinoma, a rare clinical condition characterized by ectopic thyroid adenocarcinoma within thyroglossal duct cysts (TGDCs), typically confirmed through intraoperative rapid pathology, this condition generally has a favorable prognosis. Nevertheless, comprehensive treatment guidelines across all disease stages are lacking, the purpose of this study is to report 1 case of the disease and propose the treatment plan for each stage of the disease.
    METHODS: A patient presented with thyroid swelling, classified as C-TIRADS 4A following a physical examination. Preoperative thyroid puncture identified papillary thyroid carcinoma, and genetic testing revealed a BRAF gene exon 15-point mutation. Ancillary tests showed a slightly decreased thyroid stimulating hormone (TSH) level (0.172) with no other significant abnormalities.
    METHODS: Preoperative fine-needle aspiration cytology (FNAC) confirmed right-side thyroid cancer. Intraoperative exploration uncovered a TGDC and intraoperative rapid pathology confirmed thyroglossal duct carcinoma.
    METHODS: A Sistrunk operation and ipsilateral thyroidectomy were performed.
    RESULTS: Postoperative recovery was satisfactory.
    CONCLUSIONS: Thyroglossal duct carcinoma is a rare disease affecting the neck. Due to limited clinical cases and the favorable prognosis associated with this condition, there is currently no established set of diagnostic and treatment guidelines. According to tumor size, lymph node metastasis, thyroid status and other factors, the corresponding treatment methods were established for each stage of thyroglossal duct cancer, which laid the foundation for the subsequent treatment development of this disease.
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  • 文章类型: Journal Article
    甲状舌管囊肿(TGC)是甲状腺最常见的先天性异常,约占总人口的7%。它代表甲状腺舌管残余的囊性变性,在妊娠期间未能内卷。在TGC中发生的恶性肿瘤是罕见的实体,仅占所有甲状舌管囊肿的1%。我们正在介绍一种罕见的甲状腺乳头状癌,这种情况是在甲状舌管囊肿中引起的。30岁的女性出现无痛,下巴以下逐渐进行性肿胀延伸至左侧。在检查中,在4x3x1cm范围内,在下巴下区域出现肿胀,坚定的一致性,随着舌头的吞咽和运动而移动。关于放射学调查,可见中线的小叶性囊性病变伴薄薄的隔,提示甲状舌管囊肿。患者甲状腺正常。患者接受了Sistrunk手术。在组织病理学上,甲状舌管囊肿可见甲状腺乳头状癌,侵犯囊壁和浅骨骼肌。Brentano于1911年报道了第一例甲状舌管癌。到目前为止,文献中已经报道了300例。甲状舌管囊肿中发生的癌极为罕见,(<1%的情况下)。最常见的组织学类型是乳头状模式,其次是混合(乳头状和滤泡)。鳞状细胞,Hürthle细胞,卵泡和间变性品种。甲状舌管癌的病因尚不清楚,良好的临床病史和检查均无法导致术前诊断。在目前的病例中,诊断通常在组织病理学上是偶然的。甲状舌管癌是一种罕见的疾病,对患者和外科医生来说都是一个惊喜,在出现囊性中线颈部肿块的患者中应考虑。
    Thyroglossal cyst (TGC) is the most common congenital anomaly of the thyroid gland and is found in approximately 7% of general population. It represents cystic degeneration of a remnant of the thyroglossal duct that failed to involute during gestation. Malignancy occurring in TGC is rare entity, accounting only for 1% of all thyroglossal cysts. We are presenting such a rare case of papillary thyroid carcinoma arising in a thyroglossal cyst. 30-year-old female presented with a painless, gradually progressive swelling below the chin extending to left side. On examination, swelling was noted in submental region and measuring 4 × 3 × 1 cm, firm in consistency and moves with deglutition and movement of tongue. On radiological investigations, lobulated cystic lesion in midline with thin septations was seen, suggestive of thyroglossal cyst. The thyroid of the patient was normal. Patient underwent Sistrunk procedure. On histopathology, papillary thyroid carcinoma in thyroglossal cyst was seen and it was invading cyst wall and superficial skeletal muscle. The 1st case of thyroglossal duct carcinoma was reported by Brentano in 1911. Till now 300 cases have been reported in literature. Carcinomas occurring in thyroglossal cyst are extremely rare, (< 1% cases). The most frequent histological type is papillary pattern followed by mixed(papillary and follicular), squamous cell, Hürthle cell, follicular and anaplastic variety. The etiology of thyroglossal duct carcinoma is unknown and neither good clinical history nor examination can lead to a preoperative diagnosis. Diagnosis is often incidental on histopathology as in present case. Thyroglossal duct carcinoma is a rare condition that comes as a surprise to both the patient and surgeon and should be considered in patients presenting with cystic midline neck masses.
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  • 文章类型: Journal Article
    目的:甲状舌管囊肿(TGDC)是一种常见的颈部先天性肿块。作为TGDC切除的传统手术方法,Sistrunk程序,经常留下可见的颈部疤痕,对改善化妆品效果的需求有所增加。新兴的内窥镜辅助方法为解决美容问题提供了希望。我们进行了范围审查,以评估内窥镜辅助TGDC手术的可行性和安全性。
    方法:PubMed,Embase,和Cochrane数据库。
    方法:从各自的开始日期到2023年1月检索电子数据库。关于手术方法的数据,患者人口统计学,外科手术,提取并分析术后结局。使用JoannaBriggs研究所关键评估清单评估研究的质量。
    结果:文献检索在2011年至2022年间发表了9篇文章。总的来说,这些研究中的85例患者使用各种方法成功接受了内窥镜辅助的TGDC手术,包括乳晕,腋窝乳房,经口前庭,和经口舌下。手术时间因研究而异,范围从50到480分钟。TGDC尺寸范围为直径1至3cm。并发症,包括感染,皮肤瘀伤,和构音障碍,在7例患者(8%)中报告。没有报告转换为开放手术或术后复发的病例。
    结论:内窥镜辅助手术是寻求TGDC切除术的患者的潜在替代方案,具有令人满意的美学效果,同时确保安全。然而,现有证据不足以支持内窥镜辅助TGDC手术优于传统Sistrunk手术的有效性.喉镜,2024.
    OBJECTIVE: Thyroglossal duct cysts (TGDCs) are a common congenital mass in the cervical region. As the traditional surgical approach for TGDC removal, the Sistrunk procedure, often leaves a visible neck scar, the demand for improved cosmetic outcomes has increased. Emerging endoscopy-assisted approaches offer promise for addressing cosmetic concerns. We conducted a scoping review to evaluate the feasibility and safety of endoscopy-assisted TGDC surgery.
    METHODS: PubMed, Embase, and Cochrane databases.
    METHODS: Electronic databases were searched from their respective inception dates to January 2023. Data on surgical approach, patient demographics, surgical procedure, and postoperative outcomes were extracted and analyzed. The quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist.
    RESULTS: The literature search yielded nine articles published between 2011 and 2022. Overall, 85 patients in these studies successfully underwent endoscopy-assisted TGDC surgery using various approaches, including areolar, axillo-breast, transoral-vestibular, and transoral-sublingual. The operative time varied across the studies, ranging from 50 to 480 min. TGDC sizes ranged from 1 to 3 cm in diameter. Complications, including infection, skin bruising, and dysarthria, were reported in seven patients (8%). No cases of conversion to open surgery or postoperative recurrences were reported.
    CONCLUSIONS: Endoscopy-assisted surgery is a potential alternative for patients seeking TGDC resection with satisfactory aesthetic results while ensuring safety. However, existing evidence is insufficient to support the superior effectiveness of endoscopy-assisted TGDC surgery over the traditional Sistrunk procedure. Laryngoscope, 134:3038-3043, 2024.
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  • 文章类型: Journal Article
    甲状舌管囊肿是最常见的先天性颈部肿块,但是甲状舌管囊肿中恶性肿瘤的发生率很少,估计为1%。在手术切除后偶然发现甲状舌管囊肿中出现的大多数癌症。我们介绍了8例由甲状舌管囊肿引起的甲状腺乳头状癌患者的术前影像学表现,根据超声评估,计算机断层扫描,磁共振成像,和正电子发射断层扫描。
    UNASSIGNED: 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.
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  • 文章类型: Journal Article
    甲状舌管囊肿(TGDC)在新生儿期很少出现症状,这与其他先天性颈部肿胀伴有高气道阻塞不同。新生儿出现气道受损的舌骨下TGDC甚至更罕见。我们特此报告一名新生儿,患有严重的呼吸窘迫,自出生以来需要插管和通气。他有多次拔管失败和拔管后上呼吸道阻塞的迹象。计算机断层扫描显示为囊性病变,可能是舌骨下TGDC压迫喉腔.通过Sistrunk手术切除囊肿,组织病理学证实了诊断。患儿术后5天出院,随访无症状。
    Thyroglossal duct cyst (TGDC) rarely becomes symptomatic in the neonatal period unlike other congenital neck swellings which present with high airway obstruction. An infrahyoid TGDC presenting with airway compromise in a neonate is even rarer. We hereby report a newborn with significant respiratory distress necessitating intubation and ventilation since birth. He had multiple extubation failures and signs of upper airway obstruction post-extubation. Computed tomography demonstrated a cystic lesion, probably an infrahyoid TGDC compressing the laryngeal lumen. The cyst was removed by Sistrunk procedure and histopathology confirmed the diagnosis. The child was discharged 5 days after surgery and was asymptomatic on follow-ups.
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  • 文章类型: Systematic Review
    目的:讨论我们在舌内甲状舌管囊肿(TGDC)的内镜治疗方面的机构经验,并在系统综述中回顾已发表文献中的病例。
    方法:确定了2009-2019年在我院接受内镜手术治疗的舌内TGDC患儿。然后将我们病例系列的指标与文献中的指标进行了系统评价,以评估内窥镜或经口治疗的综合结果。患者人口统计学,介绍的年龄,呈现症状学,影像学上囊肿的大小,手术类型,并对术后结果进行评估.
    结果:我们确定了文献中描述的5例舌内TGDC和48例舌内TGDC。呈现的平均年龄为20.36个月。69.8%(N=37)的患者出现至少一种呼吸道症状,22.6%(N=12)出现吞咽困难,9.4%(N=5)在口咽部有确定的肿块,15.1%(N=8)的囊肿是偶然发现的。由于先前TGDC切除不完全,三名患者需要翻修手术,一名患者在初次切除后>6个月复发,需要第二次手术。我们的数据与已发表的病例系列的系统评价相结合,证实了内窥镜或经口治疗是确定舌内TGDC治疗的绝佳选择。
    结论:舌内TDGC是TGDC的潜在威胁生命的变种。我们的结果与已发表的系统评价系列相结合,表明舌内TGDC的内窥镜或经口治疗是出色的微创治疗方法,复发风险较低。建议术后监测长达一年。
    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.
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  • 文章类型: Journal Article
    背景:起源于甲状舌管囊肿的乳头状癌是罕见且奇特的,大多数病例是在手术后发现的。尽管预后良好,它的管理仍然存在争议。在这里,我们报道了一例53岁女性,她接受了Sistrunk手术治疗甲状舌管囊肿,随后被证实患有甲状腺乳头状癌.
    方法:一名53岁女性出现前中线颈部肿块7年。患者没有甲状腺功能减退或甲状腺功能亢进的症状。此外,她没有压迫症状的病史。颈部超声显示舌骨下方见清晰的3.5cm×2.2cm×3cm大小的囊性病变,具有外围固体成分。颈部计算机断层扫描显示明确的3.7cm×3.4cm×2.7cm大小的囊性病变,中央实性成分增强,并伴有局灶性钙化。低于舌骨,并与甲状软骨的前壁接触。进行了Sistrunk程序。然后,患者被诊断为甲状腺乳头状癌,TNM分期为pT2,并接受了全甲状腺切除术作为随访程序。
    结论:甲状舌管囊肿癌通常在生命的第四个十年中发现,女性患病率较高。在初始放射学检查期间进行颈部超声检查以评估囊肿并确认甲状腺的存在。
    结论:Sistrunk程序对低风险患者非常有效。高风险患者需要更积极的方法。
    BACKGROUND: Papillary carcinoma originating from a thyroglossal cyst is rare and peculiar, with majority of cases detected after surgery. Despite an excellent prognosis, its management remains controversial. Herein, we report the case of a 53-year-old woman who underwent Sistrunk procedure for a thyroglossal duct cyst and was subsequently confirmed to have papillary thyroid carcinoma.
    METHODS: A 53-year-old woman presented with an anterior midline neck mass for 7 years. The patient had no symptoms of hypo-or hyperthyroidism. Additionally, she had no history of compressive symptoms. Neck ultrasound revealed a well-defined 3.5 cm × 2.2 cm × 3 cm-sized cystic lesion inferior to the hyoid bone, with a peripheral solid component. Neck computed tomography revealed a well-defined 3.7 cm × 3.4 cm × 2.7 cm-sized cystic lesion with an enhanced central solid component with focal calcifications, inferior to the hyoid bone, and in contact with the anterior wall of the thyroid cartilage. Sistrunk procedure was performed. The patient was then diagnosed with papillary thyroid carcinoma with TNM stage pT2 and underwent total thyroidectomy as a follow-up procedure.
    CONCLUSIONS: Thyroglossal duct cyst carcinoma is usually detected in the fourth decade of life with a higher prevalence in women. Neck ultrasound is performed during the initial radiological workup to assess the cyst and confirm the presence of the thyroid gland.
    CONCLUSIONS: The Sistrunk procedure is highly effective in low-risk patients. A more aggressive approach is required for high-risk patients.
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  • 文章类型: Review
    甲状舌管囊肿在甲状腺异位发展时的临床病理特征仍不清楚,因为它很罕见。这使得诊断变得困难。临床诊断和治疗不应忽视位于甲状腺的甲状舌管囊肿的可能性。我们在此报告当前病例,以准备其他人并为此类疾病的诊断和治疗提供数据。
    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.
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  • 文章类型: Journal Article
    颈部肿块是指可以看到的颈部的任何异常病变,触诊,或在成像时识别。这是向外科诊所介绍的最常见原因之一。
    目的是分析在尼日利亚西北部三级中心诊断和管理颈部肿块的儿童的临床表现和治疗结果。
    回顾了2013年1月至2019年12月期间7年以上颈部肿块患者的记录。使用统计产品和服务解决方案23.0版软件(SPSSInc.,芝加哥,伊利诺伊州,美国)。
    共审查了99例病例,其中男性52例(52.5%),女性47例(47.5%),男女比例为1.1:1,平均年龄±标准差为4.4±3.9岁,所有患者的主诉均为颈部肿胀.前三角是86例(86.9%)患者中最常见的区域。大多数颈部肿块是先天性的,占71例(71.8%)。超声扫描是87例(87.8%)患者中最常见的放射学检查。
    甲状舌管囊肿是41例(41.4%)患者中最常见的小儿颈部肿块。大多数患者68(68.7%)进行了病灶切除活检。手术部位感染是7.1%研究人群中最常见的并发症。
    大多数颈部肿块是先天性的,通过手术治疗。及时诊断与适当的治疗可能会导致良好的结果。
    UNASSIGNED: A neck mass is any abnormal lesion in the neck that can be seen, palpated, or identified on imaging. It is one of the most common reasons for presentation to the surgical clinics.
    UNASSIGNED: the aim is to analyse the clinical presentation and treatment outcome in children who were diagnosed and managed for neck masses in a tertiary centre in Northwestern Nigeria.
    UNASSIGNED: The records of patients managed for neck masses over 7 years between January 2013 and December 2019 were reviewed. Demographic and clinical data were retrieved and analysed using Statistical Product and Service Solution version 23.0 software (SPSS Inc., Chicago, Illinois, USA).
    UNASSIGNED: A total of 99 cases were reviewed and there were 52 (52.5%) males and 47 (47.5%) females with male-to-female ratio of 1.1:1, and mean age ± standard deviation of 4.4 ± 3.9 years, the primary complaints of all the patients were neck swellings. The anterior triangle was the most common region involved in 86 (86.9%) patients. The majority of the neck masses were congenital, accounting for 71 (71.8%) patients. Ultrasound scanning was the most commonly requested radiological investigation done in 87 (87.8%) patients.
    UNASSIGNED: Thyroglossal duct cyst was the most common paediatric neck mass seen in 41 (41.4%) patients. The majority of the patients 68 (68.7%) had an excisional biopsy of the lesion. Surgical site infection was the most common complication noted in 7.1% of the study population.
    UNASSIGNED: Most of the neck masses were congenital and were managed surgically. Prompt diagnosis with appropriate treatment may result in a good outcome.
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