A rare case of congenital thyroglossal cyst with cysto-tracheal fistula: case report

Česká verze

Authors: P. Krupičková ¹; R. Katra ²; Z. Mormanová ³; Z. Hříbal ⁴; M. Jurovčík ²; Michal Černý ¹
Authors place of work: Novorozenecké oddělení s JIRP, Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha ¹; Klinika ušní, nosní a krční 2. LF UK a FN Motol, Praha ²; Novorozenecké oddělení, Krajská nemocnice Liberec, a. s. ³; Klinika zobrazovacích metod 2. LF UK a FN Motol, Praha ⁴
Published in the journal: Čes-slov Pediat 2017; 72 (7): 436-440.
Category: Kazuistika

Kazuistika byla publikována formou posteru na XXIX. neonatologických dnech s mezinárodní účastí, Ústí nad Labem, 6.–8. 11. 2013.

Summary

Thyroglossal cyst is one of the most frequent congenital anomaly in cervical region. It usually manifests before the age of 10 years as a painless swelling in the middle of the neck near the hyoid bone. The thyroglossal cyst arises from the persistent obliterated remnant of thyroglossal duct, an embryonic pouch descending from foramen caecum in the embryonic period to form thyroid gland. Diagnosis is usually based on clinical and sonographic examination, accompanied by CT or MR imaging if needed. Treatment of choice is Sistrunk procedure: surgical resection of the cyst along with the hyoid bone. The most common complications include infection, recurrence of the cyst or fistula formation. Rarely a well-differentiated thyroid carcinoma is found in the tissue of the cyst.

Here we present an uncommon case of thyroglossal cyst with cysto-tracheal fistula, which was found in a full-term newborn. The cyst was manifested as a soft swelling on the left side of the neck, the neonate also suffered from respiratory distress with wheezing and stridor. Ultrasound and magnetic resonance showed a cyst filled with fluid and air, deviating soft tissues and trachea. The diagnostic puncture of the cyst was performed followed by a contrast X-ray examination to detect tracheal fistula. Due to the respiratory complications the cyst was surgically extirpated 8 days after birth, together with the tracheal fistula. Histological analysis showed thyroglossal duct tissue. After discharge the patient was followed up, the control MR showed complete healing of the wound and returning of the neck structures into the physiological position.

The aim of this paper is to emphasize the wide differential diagnosis of congenital cervical cysts and to demonstrate the possibility of surgical treatment in the newborn period.

Keywords:
neck cyst, thyroglossal duct, congenital anomaly, thyroid gland, children

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