소아와 성인 갑상설관 낭종 환자군의 비교
Single Institutional Experience of Thyroglossal Duct Cyst; A Comparison between Children and Adults
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Purpose: Thyroglossal duct cyst (TGDC) is known to be the most common midline neck mass in children, but the adult population still has this abnormality. The most common symptom of TGDC is a simple neck mass, and differential diagnosis among other abnormalities is important. The aim of this study is to perform a retrospective view of TGDC in order to describe any differences in clinical features, diagnostic tools, treatment, and outcomes in children and adults who underwent surgery in a single institution, and to determine its clinical implications. Methods: We performed a retrospective chart review on 75 pathologically diagnosed TGDC patients from 1995 to 2013 who were divided into two groups: children (≤18 years) and adults. Comparison analysis was performed for age, sex, site and location of cyst, size, diagnostic tool, surgical method, and postoperative outcome. Results: Our study showed frequent occurrence of TGDC in adults. There was no significant sex, site, or location difference in the occurrence of TGDC in children and adults, however, the size of cyst in adults was larger than that in children (mean, 2.80 cm vs 2.15 cm) (P＜ 0.001). Four patients (5.3%) had postoperative recurrence of TGDC, and Sistrunk operation showed lower recurrence rate than excision (3.1% vs 18.2%) (P＜0.040). Two malignancy cases were identified postoperatively in adults. Conclusion: Particularly in adults, the possibility of carcinoma would make it important to perform fine-needle aspiration for differential diagnosis. Sistrunk procedure will remain the treatment of choice for most TGDC patients considering recurrence risk.
Abstract
Purpose: Thyroglossal duct cyst (TGDC) is known to be the most common midline neck mass in children, but the adult population still has this abnormality. The most common symptom of TGDC is a simple neck mass, and differential diagnosis among other abnormalities is important. The aim of this study is to perform a retrospective view of TGDC in order to describe any differences in clinical features, diagnostic tools, treatment, and outcomes in children and adults who underwent surgery in a single institution, and to determine its clinical implications. Methods: We performed a retrospective chart review on 75 pathologically diagnosed TGDC patients from 1995 to 2013 who were divided into two groups: children (≤18 years) and adults. Comparison analysis was performed for age, sex, site and location of cyst, size, diagnostic tool, surgical method, and postoperative outcome. Results: Our study showed frequent occurrence of TGDC in adults. There was no significant sex, site, or location difference in the occurrence of TGDC in children and adults, however, the size of cyst in adults was larger than that in children (mean, 2.80 cm vs 2.15 cm) (P＜ 0.001). Four patients (5.3%) had postoperative recurrence of TGDC, and Sistrunk operation showed lower recurrence rate than excision (3.1% vs 18.2%) (P＜0.040). Two malignancy cases were identified postoperatively in adults. Conclusion: Particularly in adults, the possibility of carcinoma would make it important to perform fine-needle aspiration for differential diagnosis. Sistrunk procedure will remain the treatment of choice for most TGDC patients considering recurrence risk.
참고문헌 (19)
- Allard RH, "The thyroglossal cyst", Head Neck Surg, 5, pp.134~146 (1982)
- Tunkel DE, "Radioisotope scanning of the thyroid gland prior to thyroglossal duct cyst excision", Arch Otolaryngol Head Neck Surg, 124, pp.597~599 (1998)
- Ren W, "Presentations and management of thyroglossal duct cyst in children versus adults: a review of 106cases", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 111, pp.e1~e6 (2011)
- Brousseau VJ, "Thyroglossal duct cysts: presentation and management in children versus adults", Int J Pediatr Otorhinolaryngol, 67, pp.1285~1290 (2003)
- Sistrunk WE, "The surgical management of cysts of the thyroglossal tract", Ann Surg, 71, pp.121~122 (1920)
- Shahin A, "Thyroglossal duct cyst:a cytopathologic study of 26 cases", Diagn Cytopathol, 33, pp.365~369 (2005)
- Lin ST, "Thyroglossal duct cyst: a comparison between children and adults", Am J Otolaryngol, 29, pp.83~87 (2008)
- Dedivitis RA, "Thyroglossal duct: a review of 55 cases", J Am Coll Surg, 194, pp.274~277 (2002)
- Ahuja AT, "Thyroglossal duct cysts: sonographic appearances in adults", AJNR Am J Neuroradiol, 20, pp.579~582 (1999)
- Ahuja AT, "Sonographic evaluation of thyroglossal duct cysts in children", Clin Radiol, 55, pp.770~774 (2000)
- Al-Khateeb TH, "Congenital neck masses: a descriptive retrospective study of 252 cases", J Oral Maxillofac Surg, 65, pp.2242~2247 (2007)
- Chen KT, "Cytology of thyroglossal cyst papillary carcinoma", Diagn Cytopathol, 9, pp.318~321 (1993)
- Patel SG, "Management of well-differentiated thyroid carcinoma presenting within a thyroglossal duct cyst", J Surg Oncol, 79, pp.134~139 (2002)
- Luna-Ortiz K, "Thyroglossal duct cyst with papillary carcinoma:what must be done?", Thyroid, 14, pp.363~366 (2004)
- Athow AC, "Management of thyroglossal cysts in children", Br J Surg, 76, pp.811~814 (1989)
- Bennett KG, "Is the treatment for thyroglossal duct cysts too extensive?", Am J Surg, 152, pp.602~605 (1986)
- Heshmati HM, "Thyroglossal duct carcinoma: report of 12 cases", Mayo Clin Proc, 72, pp.315~319 (1997)
- Kennedy TL, "Thyroglossal duct carcinoma:a rational approach to management", Laryngoscope, 108, pp.1154~1158 (1998)
- Plaza CP, "Management of well-differentiated thyroglossal remnant thyroid carcinoma: time to close the debate? Report of five new cases and proposal of a definitive algorithm for treatment", Ann Surg Oncol, 13, pp.745~752 (2006)