Bechara Y. Ghorayeb, MD. 1140 Business Center Drive, Suite 560. Houston, TX 77043. Phone: (713) 464 2614
Excision of Thyroglossal Duct Cyst
Thyroglossal duct cysts result from aberrant embryological development of the thyroid gland. During the fourth week of fetal growth, the thyroid gland develops from tissue located in the base of the tongue. This tissue migrates down into the neck and reaches its final destination in front of the trachea, about the 8th week of pregnancy. During its descent, the thyroid gland remains connected to the base of the tongue by the thyroglossal duct, which disappears as the thyroid reaches its final position in the neck. Persistence of this embryonic duct results in the formation of a sac of tissue or cyst that will fill up with mucus and fluid. Large cysts could cause difficulty in swallowing and airway obstruction. Occasionally, they get infected and form abscesses that require incision and drainage. Thyroglossal duct cysts are frequent in children and adolescents. The majority, 31%, occur in patients before the age of 10 years, 20% between 10 and 20 years, 14% between 20 and 30 years, and 35% after the age of 30 years.
Could a thyroglossal duct cyst become malignant?
Malignancy in a thyroglossal duct cyst is extremely rare (about 1%). In general, cancers do not occur in children, but are more likely to occur in females between 30 and 40 years of age.
How is a thyroglossal duct cyst treated?
There is no medical treatment. Surgical treatment is directed at removal of the cyst and the connected duct. The duct is followed superiorly to the base of the tongue. A small piece of the hyoid bone is also removed with the cyst and the attached duct. This operation is called the Sistrunk procedure. Complications are infrequent. Like any operation, there is a small chance of post operative infection or bleeding. Finally, a thyroglossal duct cyst has a small chance of regrowing if small portions of the tissues remain after surgery. Infection of the cyst prior to surgery can make the removal more difficult and increase the chance for regrowth. As mentioned above, in adults, thyroid cancer can occur inside a thyroglossal duct cyst and may require further surgical treatment.
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