Background: Thyroglossal duct cysts (TGDC) are the most common congenital midline neck mass typically diagnosed in patients before the age of 20; however, they can occur at any age and sometimes develop together with other thyroid disorders. Clinical profiles of adult TGDC are scarce due touncommon occurrence in adults.
Material and Method: A retrospective 20-year (1998-2018) of TGDC was reviewed and analyzed at Theptarin Hospital, one of largest endocrine centers in Bangkok.
Results: A total of 28 TGDC patients (male 46.4 %, mean age 43.2±17.3 years, mean age at diagnosis 40.3±19.6 years) were seen in our hospital during study period. The mean cyst size was 3.0±2.3 cm (1.1-14.0 cm) and located in midline observed in 71.4% of patients followed by laterality in the left side in 21.4% of patients. Only 2 patients (7.1%) were presented with a lateral neck mass in the right side. Misdiagnosis of TGDC as thyroid nodules was found in 28.6% of patients with the median duration of misdiagnosis for 2.4 years. Concurrent various thyroid disorders were seen in 5 from 28 patients (17.9%). Definitive surgery was offered in only 64.3% of patients but only one patient underwent Sistrunk operation at our center. Two patients chose to treat with percutaneous ethanol injection (PEI) after excluding malignancy. However, only one patient completed the course of PEI treatments (5 times) with mean volume reduction at 70% at 6 months. No malignancy arising from TGDC was observed in our series.
Conclusion: Misdiagnosis of TGDC was still common in almost one-third of patients and laterality of TGDC to the left side could be found in one-fourth of adult patients, consistent with other reports. PEI treatment could be an alternative treatment in selected patients after excluding malignancy.