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Hürthle cell adenoma of the thyroglossal duct fistula
Author(s) -
Baek SeungCheol,
Houh Dong,
Byun DaeGyoo,
Cho BaikKee
Publication year - 1998
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1046/j.1365-4362.1998.00475.x
Subject(s) - thyroglossal duct , medicine , hyoid bone , anatomy , cyst , thyroid cartilage , fistula , cribriform plate , tongue , thyroid , larynx , radiology , pathology
A 41‐year‐old man noted the presence of a punched‐out ulcer on the anterior midline of the neck. There was no previous history of trauma or radiation to the head and neck region. Physical examination showed a draining sinus surrounded by a cribriform scar on the anterior midline of the neck ( Fig. 1). There was no adenopathy in the neck. The head and neck were otherwise normal, as were T3 and T4, routine blood and urine tests, and chest X‐rays. Thyroid scan was performed which demonstrated normal uptake and normal location of the thyroid gland. Computed tomographic scan showed a 2.5×1.0×1.0‐cm‐sized ovoid, hypodense cystic mass extending to the cricoid cartilage. Because there was doubt as to the extent of the fistulous tract and its ramifications, a roentgen study of the tract after injection of a contrast medium was performed. The fistulogram showed that the injected contrast medium was observed at the base of the tongue through a faintly opacified thread‐like fistulous tract from the skin. 1Punched‐out ulcer surrounded by cribriform scar on the anterior midline of the neck At surgical exploration, a thyroglossal duct tract was identified and a Sistrunk procedure was performed. This involved the removal of the thyroglossal duct cyst and the central portion of the hyoid bone, and the tracing of the thyroglossal duct tract to the foramen cecum at the base of the tongue. The pathology of the thyroglossal mass showed a thyroglossal duct cyst lined by columnar epithelium and small acini, with solid groups of large polyhedrial or round cells with pleomorphic hyperchromatic nuclei and eosinophilic granular cytoplasm, consistent with Hürthle cell adenoma ( Figs 2 and 3). No evidence of capsular invasion or penetration was observed. The patient was discharged in a good condition 1 week later, and was well at follow‐up 6 months later. 2Hürthle cell adenoma (right) and thyroglossal duct cyst lined by columnar epithelium (left) are seen on the photomicrograph of the resected specimen (hematoxylin and eosin stain;×50)3High‐power photomicrograph of the Hürthle cell adenoma showing polyhedrial or round cells with abundant eosinophilic granular cytoplasm and pleomorphic hyperchromatic eccentric nuclei (hematoxylin and eosin stain;×400)