Incidental radiographic findings of thyroglossal duct cysts: Prevalence and management.
OBJECTIVE
To determine the epidemiology of incidental thyroglossal duct cysts (TGDC) discovered on imaging studies obtained in the head and neck area in children and to discuss subsequent management.


METHODS
A retrospective chart review was performed at Texas Children's Hospital of all computed tomography (CT) and magnetic resonance (MR) imaging studies obtained in the head and neck region between July 2011 and July 2014. Images obtained for the purpose of evaluating a neck or lingual mass were excluded from the study, as were patients with previously known TGDCs. Data including age, sex, location of TGDC, size, presence of symptoms, referral to Otolaryngology, and intervention were recorded.


RESULTS
A total of 60,663 CT and MR studies of the head, brain, sinus, neck, and C-spine during this time period were reviewed; of these 69 (0.1%) cases contained incidental discovery of probable TGDCs with more males (40) than females (29). Ages ranged from 3 days to 17 years old, with the mean age at 5 years. Locations varied, with majority at base of tongue (83%) followed by hyoid (13%) then infrahyoid straps (4%). Sizes ranged from 2 to 28 mm with average size at 8 mm. 11 of these patients were referred to an Otolaryngologist; 9 were asymptomatic and decision was made to observe, the other two subsequently underwent surgical excision secondary to mass effect and dysphagia with histologic confirmation of diagnosis.


CONCLUSIONS
TGDCs commonly present as an anterior neck mass, however the majority of incidentally discovered TGDCs on imaging are located at the base of tongue. Management of these findings should include referral to an Otolaryngologist for further evaluation with the decision to intervene surgically based on development of clinical symptoms.
Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, One Baylor Plaza, Mail Stop: NA-102, Houston, TX 77030, USA. Electronic address: myim@bcm.edu.
Michael T
MT
Yim
Department of Pediatric Radiology, Neuroradiology Section, Texas Children's Hospital, 6701 Fannin Street, Suite 470, MC 2-270, Houston, TX 77030, USA. Electronic address: hdtran@texaschildrens.org.
Huy D
HD
Tran
Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, One Baylor Plaza, Mail Stop: NA-102, Houston, TX 77030, USA; Division of Otolaryngology, Texas Children's Hospital, Houston, TX, USA. Electronic address: bmchandy@texaschildrens.org.
Binoy M
BM
Chandy
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D019468:Disease Management; D005260:Female; D006801:Humans; D006928:Hyoid Bone / Q000000981:diagnostic imaging; D033162:Incidental Findings; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D010036:Otolaryngology; D015995:Prevalence; D012017:Referral and Consultation; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D013955:Thyroglossal Cyst / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D014060:Tongue Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy
Imaging; Incidental finding; Pediatric neck mass; Thyroglossal duct cyst