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CLINICAL IMAGES Table of Contents  
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High-resolution ultrasonography of infected thyroglossal duct cyst


 Department of Radiology, St. John's Hospital, Bengaluru, Karnataka, India

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Date of Submission29-Jul-2021
Date of Decision19-Jul-2021
Date of Acceptance03-Sep-2021
Date of Web Publication18-Oct-2021
 


How to cite this URL:
Reddy R. High-resolution ultrasonography of infected thyroglossal duct cyst. Apollo Med [Epub ahead of print] [cited 2021 Nov 30]. Available from: https://www.apollomedicine.org/preprintarticle.asp?id=328541





  Description Top


A 22-year-old male presented to the department of general surgery with complaints of progressive increase in size of the neck mass in the anterior neck since 2 years. The mass lesion measures approximately 2 cm × 3 cm is noted to move with deglutition. However, since the past 1 week, he had experienced pain in the region of the mass while swallowing. High-resolution ultrasonography demonstrated a well-defined cystic lesion measuring 2.2 cm × 2.6 cm × 3.2 cm with multiple internal echoes located in the anterior aspect of neck just below the level of hyoid bone to the right of midline [Figure 1]a. Color Doppler examination did not demonstrate vascularity [Figure 1]b. Fine-needle aspiration cytology (FNAC) was suggestive of infected thyroglossal duct cyst (TDC). Complete surgical excision of the infected TDC was performed. Postoperative recovery period was uneventful. Histopathology of the resected specimen confirmed the provisional diagnosis of infected TDC. At 3 months' follow-up, the patient was symptom free with no signs of recurrence.
Figure 1: (a) High-resolution ultrasonography image demonstrating a well-defined cystic lesion with multiple internal echoes below the level of hyoid bone to the right of midline suggesting infected thyroglossal duct cyst. (b) Color Doppler ultrasonography image demonstrating no internal vascularity within the cystic mass

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  Discussion Top


TDC is a midline cystic lesion which is commonly encountered in children and generally not accompanied by pain unless infected. TDC demonstrates movement with tongue protrusion and deglutition. TDC has fixed anatomical landmarks related to the embryological descent of the thyroid gland which include the sternum, level of thyroid cartilage, thyrohyoid membrane, hyoid bone, and foramen cecum of the tongue base [Figure 2].[1] However, TDC is mostly infrahyoid in location (65%).[2] However, TDC needs to be differentiated from miscellaneous cystic lesions of the neck such as branchial cleft cyst, neck abscess, lymphatic malformation, and squamous cell carcinoma with cystic metastases to cervical lymph nodes.[3] Nevertheless, high-resolution ultrasonography supplemented by FNAC is a pretreatment requisite in majority of cases with TDC. Following treatment of the infected TDC with antibiotics, Sistrunk operation is performed for resection and to prevent recurrence.
Figure 2: Schematic diagram depicting the possible sites (stars) of occurrence of thyroglossal duct cyst along the path of embryological descent of thyroid gland

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initial s will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Acknowledgment

I would like to thank Ms. Babika and Ms. Sweta for the help rendered in the preparation of schematic diagram.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Bhargava P, Parisi M. Infected thyroglossal duct cyst. Pediatr Radiol 2010;40 Suppl 1:S84.  Back to cited text no. 1
    
2.
Mohan PS, Chokshi RA, Moser RL, Razvi SA. Thyroglossal duct cysts: A consideration in adults. Am Surg 2005;71:508-11.  Back to cited text no. 2
    
3.
Zander DA, Smoker WR. Imaging of ectopic thyroid tissue and thyroglossal duct cysts. Radiographics 2014;34:37-50.  Back to cited text no. 3
    

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Correspondence Address:
Ravikanth Reddy,
Department of Radiology, St. John's Hospital, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/am.am_87_21



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