Special aspects in the sonography of thyroglossal cysts

Introduction:

Sonography of thyroglossal cysts is not that difficult. If a contact to the hyoid can be seen, the diagnosis is easy. But there are special features which should be considered for a correct surgical planning. These are the detection of parts of the cyst within the tongue base as well as the detection of thyroid tissue within the cyst.

Methods:

The sonografic findings of 41 patients suffering from a thyroglossal cyst who contacted our department (1/2012 – 6/2018) was compared with the intraoperative finding and the histological result.

Results:

In all 37 of the 41 patients underwent surgery. In 35/41 patients (85%) the cyst was located only distally to the hyoid. In 5/41 patients (12%), the cyst was located only within the tongue base and in one patient a combined process was seen. In 18 cases, were the cyst was found distally of the hyoid, thyroid tissue was seen histologically. One of these patients even suffered from papillary thyroid cancer. Among the patients with parts of the cyst within the tongue base, one had thyroid tissue within the cyst which was seen sonografically as well as histologically. In one patient with goitre of the tongue base, surgery was not performed because of the patients age.

Conclusion:

Parts of the thyroglossal cyst located within the tongue basecan easy be detected preoperatively by sonography, if this area is examined correctly. Thereby the detection of tissue within the tongue base is essential for correct surgical planing. Thyroid tissue can be identified sonographically, if major parts of the cyst are solid. The results also show that the sonographer should be familiar with criteria of thyroid malignancy, to initialize the correct therapy as early as possible in case of cancer.

Publication History

Publication Date:
23 April 2019 (online)