Coexistence of Thyroglossal Cyst and Thyroid Disease in Adults: Surgical Outcomes From A Single Center

Introduction: Thyroglossal cysts (TGCs) usually present during childhood and before the age of 30, however they can also be seen in adults, even in advanced age. Nodular thyroid disease is also common in adults. In the literature, there is an ongoing debate regarding the differences in clinical presentation, gender, and postoperative recurrence of TGC between children and adults. In this study, we aimed to process the data of adult patients who underwent surgery for TGC in our clinic, along with the data on concurrent thyroid disease and thyroid surgery.
Materials and Methods: The data of patients over 18 years old who were operated on for TGC at the General Surgery Clinic of Sisli Hamidiye Etfal Training and Research Hospital between 2018 and 2024 were retrospectively evaluated.
Results: A total of 16 patients with a mean age of 43.94 ± 12.98 (21-67) years, were included in the study (11 F/5 M). The diagnosis of TGC was made in 12 patients (75%) by ultrasonography (USG), in 1 patient (6.25%) by computed tomography, in 1 patient (6.25%) by magnetic resonance imaging (MRI), and in 2 patients (12.5%) incidentally intraoperatively. 13 patients (81.25%) underwent the Sistrunk procedure, and 3 patients (18.75%) underwent cyst excision. Among the 16 TGC patients, papillary thyroid cancer in the cyst was detected in one patient (6.25%) preoperatively. During preoperative evaluation, nodular thyroid disease was found in 12 patients (75%). Of these, papillary thyroid cancer was detected in 3 patients (18.75%) preoperatively. Of the TGC group, 3 (18.75%) underwent thyroidectomy for thyroid malignancy, and five (31.25%) underwent additional thyroid surgery for nodular thyroid disease. The patients were followed for a mean of 22.63 ± 18.32 months (3-67 months), and no recurrence of TGC was observed during the follow-up period.
Conclusion: In patients with TGC, thyroid diseases and the requirement for thyroidectomy due to benign or malignant thyroid disease is not uncommon. Patients with TGC should be evaluated for thyroid disease before surgical treatment. While the Sistrunk procedure is the standard surgical technique in the treatment of TGC, in adults, if the cyst terminates below the hyoid bone, total cyst excision without removing the central portion of the hyoid bone may be sufficient.

Yetiþkinlerde Tiroglossal Kist ve Tiroid Hastalýðý Birlikteliði: Tek Merkez Cerrahi Tedavi Sonuçlarý

Giriþ: Tiroglossal kist (TGC)’ler genellikle çocukluk çaðýnda ve 30 yaþýndan önce presente olmasýna raðmen, yetiþkinlerde hatta ileri yaþlarda da görülebilmektedir. Yetiþkinlerde nodüler tiroid hastalýðý da sýk görülmektedir. Literatürde çocuk ve yetiþkinlerde TDC kliniðinin, cinsiyetin, cerrahi sonrasý rekürensin farklý olduðu ile ilgili tartýþmalar devam etmektedir. Biz de bu çalýþmada kliniðimizde TDC nedeni ile cerrahi uygulanan yetiþkin hastalarýn TDC ile ilgili verileri, eþ zamalý tiroid hastalýðý ve tiroid cerrahisi ile ilgili verilerini deðerlendirmeyi amaçladýk
Materyal Metod: Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi Genel Cerrahi Kliniðinde 2018-2024 tarihleri arasýnda TGC tanýsý opere edilen 18 yaþ üstü hastalarýn verileri retrospektif olarak deðerlendirildi.
Bulgular: Kriterlere uygun yaþ ortalamasý 43.94+12.98 (21-67) yýl olan 16 hasta (11 kadýn/5 erkek) çalýþmaya alýndý. TGC tanýsý 12 hastada 8%75) ultrasonografi (USG), 1 hastada (%6.25), 1 hastada magnetik rezonans görüntüleme, 2 hastada insidental olarak (12.5) intraoperatif saptandý. TGC için 13 hastaya (%81.25) Sistrunk ameliyatý, 3 hastaya (%18.75) kist eksizyonu uygulandý. 16 TGC’li hastanýn birinde (%6.25) preoperatif TGC içinde papiller tiroid kanseri saptandý. Preoperatif deðerlendirmede 12 hastada (%75) nodüler tiroid hastalýðý saptandý. Bunlarýn 3 (%18.75)’ünde preoperatif papiller tiroid kanseri saptandý. TGC’li hastalardan 3’üne (%18.75) tiroid malignitesi, 5 (%31.25)’ine nodüler tiroid hastalýðý nedeniyle (%50)’ine ek tiroid cerrahisi uygulandý. Hastalar 22.63+18.32 ay (3-67 ay) takip edildi. Takip süresinde TGC rekürensi geliþmedi.
Sonuç: TGC’li hastalarda tiroid hastalýðý, malign veya benign tiroid hastalýðý için ek tiroidektomi gerekliliði nadir deðildir. TGC’li hastalar cerrahi tedavi öncesi tiroid hastalýðý açýsýndan da deðerlendirilmelidir. TGC’li hastalarýn cerrahi tedavisinde Sistrunk ameliyatý standart cerrahi teknik olmasýna raðmen, yetiþkinlerde eðer kist hyoid kemiðin inferiorunda sonlanýyorsa hyoid kemik ortasý çýkarýlmadan total kist eksizyonu yeterli olabilir. (SETB-2024-09-149)