Preoperative evaluation of thyroglossal duct cysts: children versus adults--is there a difference?

BACKGROUND: Thyroglossal duct cysts (TGDCs) are common in children but also present in adults. This study evaluates the preoperative management and postoperative outcomes in patients with a resected TGDC.

METHODS: A retrospective analysis was performed on patients with a surgically treated TGDC. Clinicopathologic variables and treatment outcomes were obtained by chart review.

RESULTS: A total of 79 patients (44 pediatric and 35 adult) were identified. The majority of patients in both groups presented with a neck mass. Compared with children, adults were significantly more likely to undergo preoperative imaging and fine-needle aspiration biopsy. Malignancy was not identified in any patient on preoperative workup or postoperative pathology.

CONCLUSIONS: Adults with a TGDC are more likely to undergo preoperative imaging and biopsy. The infrequent occurrence of TGDC cancer or concurrent thyroid pathology suggests that the diagnosis of a TGDC may be made on clinical grounds in adult patients although ultrasound (±fine-needle aspiration biopsy) may be a useful supplementary modality.