Clinicopathologic Case Series Of Thyroglossal Cyst In A Tertiary Care Center

Abstract

Background:
Thyroglossal duct cysts (TGDCs) are the most common congenital midline neck lesions resulting from persistent remnants of the thyroglossal duct. Although typically presenting in childhood, TGDCs may manifest at any age with varied clinical and radiological features, occasionally posing diagnostic challenges.

Aim:
To analyze the clinicopathological characteristics, anatomical distribution, and radiological features of histopathologically confirmed TGDCs in a tertiary care center.

Materials and Methods:

A retrospective observational study was conducted in the Department of Pathology at Sri Ramachandra Medical College and Research Institute from January 2016 to September 2025. A total of 65 formalin-fixed paraffin-embedded tissue blocks of surgically resected TGDCs were reviewed. Clinical details, including age, sex, site, and radiological findings, were retrieved from the laboratory information system. Hematoxylin and eosin–stained sections were examined, and results were correlated with clinicopathological parameters.

Results:
Among the 65 patients evaluated, males constituted the majority at 74%, while females accounted for 26%, reflecting a clear male predominance, with ages ranging from 2 to 50 years (mean: 17.3 years; median: 12.5 years). The infrahyoid region was the most common site (90.8%), followed by suprahyoid and intralingual locations (4.6% each). Classical clinical presentation of a midline neck swelling moving with deglutition and tongue protrusion occurred in 72.3% of patients. Ultrasonography was performed in 86.2% of cases and demonstrated typical anechoic cystic lesions, while CT and MRI were utilized in 18.5% of cases each, aiding in the identification of atypical features and tract delineation. In this study of 65 cases, respiratory epithelium alone was seen in 7.69%, squamous epithelium in 1.54%, and a combination of both in 10.77%. Inflammation was present in 18.46%, mucoserous glands in 3.08%, and hyoid bone involvement in 20.00%. Thyroid tissue was identified in 15.38% of specimens. Cyst wall alone was noted in 7.69%, with skeletal muscle or adipose tissue components each occurring in 1.54%. Skeletal muscle alone was found in 3.08%, adipose tissue alone in 1.54%, and no case showed a combination of both. Papillary thyroid carcinoma was detected in 7.69% of cases.

Conclusion:
Thyroglossal duct cysts are predominantly benign congenital neck lesions that commonly present in the infrahyoid region during childhood and adolescence. Ultrasonography remains the primary diagnostic tool, with CT and MRI aiding in atypical cases. Histopathologic evaluation confirms their embryologic origin and low malignant potential. Accurate clinicopathological correlation ensures appropriate surgical management and minimizes recurrence.