European Archives of Oto-Rhino-Laryngology

, Volume 266, Issue 11, pp 1775–1779 | Cite as

Cholesterol granuloma in thyroglossal cysts: a clinicopathological study

  • Itzhak Shvili
  • Tuvia Hadar
  • Rima Sadov
  • Rumelia Koren
  • Jacob Shvero
Head and Neck

Abstract

Thyroglossal duct cyst (TDC) is a congenital anomaly caused by retention of epithelial remnants from the descent of the thyroid gland during embryological development. Cholesterol granuloma represents a granulomatous reaction to precipitates of cholesterol crystals in tissue, usually related to middle-ear disease. The association of TDC with cholesterol granuloma has hardly been reported. This study describes five patients with TDC and cholesterol granuloma over a 16-year-period. The treatment consisted of excision of the TDC and the mid-portion of the hyoid bone and excision of a core of tissue between the hyoid bone and the foramen cecum (Sistrunk procedure). We speculate that the pathogenesis of cholesterol granuloma in TDC resembles that in the paranasal sinuses, as both sites provide a closed, poorly ventilated hollow structure with slow drainage. Our five patients accounted for 13% of all patients with TDC treated in our center during the same period, indicating that cholesterol granuloma in TDC may not be as rare as previously thought.

Keywords

Thyroglossal duct cyst Cholesterol granuloma Hemorrhage 

Notes

Conflict of interest statement

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

References

  1. 1.
    Boyd JD (1950) Development of the thyroid and parathyroid glands and the thymus. Ann R Coll Surg Engl 7:455–471PubMedGoogle Scholar
  2. 2.
    Ellis PD, van Nostrand AW (1977) The applied anatomy of thyroglossal tract remnants. Laryngoscope 87:765–770PubMedCrossRefGoogle Scholar
  3. 3.
    Pollock WF, Stevenson EO (1966) Cysts and sinuses of the thyroglossal duct. Am J Surg 112:225–232PubMedCrossRefGoogle Scholar
  4. 4.
    Mondin V, Ferlito A, Muzzi E, Silver CE, Fagan JJ, Devaney KO, Rinaldo A (2008) Thyroglossal duct cyst: personal experience and literature review. Auris Nasus Larynx 35:11–25PubMedCrossRefGoogle Scholar
  5. 5.
    Hellquist HB (1990) Pathology of the nose and paranasal sinuses. Butterworth Ltd, Oxford, pp 74–76Google Scholar
  6. 6.
    Leon ME, Chavez C, Fyfe B, Nagorsky MJ, Garcia FU (2002) Cholesterol granuloma of the maxillary sinus. Arch Pathol Lab Med 126:217–219PubMedGoogle Scholar
  7. 7.
    Thevendran G, Al-Akraa M, Powis S, Davies N (2003) Cholesterol granuloma of the kidney mimicking a tumour. Nephrol Dial Transplant 18:2449–2450PubMedCrossRefGoogle Scholar
  8. 8.
    Nativ O, Mor Y, Nass D, Leibovitch I, Goldwasser B (1995) Cholesterol granuloma of the tunica vaginalis mimicking a neoplasm. Isr J Med Sci 31:235–236PubMedGoogle Scholar
  9. 9.
    al-Amer AF, Walia HS, Madda JP (1990) Cholesterol granuloma of the peritoneum. Can J Surg 33:410–413PubMedGoogle Scholar
  10. 10.
    Bundgaard N, Eriksen HE, Greisen O (1987) Inflamed adenolymphoma with cholesterol granuloma. J Laryngol Otol 101:967–970PubMedCrossRefGoogle Scholar
  11. 11.
    Rubinstein A, Brenner S (1982) Idiopathic lipogranulomatosis of spleen and periaortic lymph nodes with noncaseating granulomas of liver. Hum Pathol 13:1133–1135PubMedCrossRefGoogle Scholar
  12. 12.
    Shvili I, Hadar T, Shvero J, Feinmesser R, Koren R (2005) Cholesterol granulomas in antrochoanal polyps: a clinicopathologic study. Eur Arch Otorhinolaryngol 262:821–825PubMedCrossRefGoogle Scholar
  13. 13.
    Aviel A, Segal M, Ostfeld E, Marshak G (1983) Cholesterol granuloma in a thyroglossal duct cyst. A case report. J Laryngol Otol 97:379–381PubMedCrossRefGoogle Scholar
  14. 14.
    Chow LT, Lee JC, Chow WH, Chan SK (1996) Cholesterol-rich thyroglossal cyst: report of a case diagnosed by fine needle aspiration. Acta Cytol 40:377–379PubMedGoogle Scholar
  15. 15.
    Shahin A, Burroughs FH, Kirby JP, Ali SZ (2005) Thyroglossal duct cyst: a cytopathologic study of 26 cases. Diagn Cytopathol 33:365–369PubMedCrossRefGoogle Scholar
  16. 16.
    Sistrunk WE (1920) The surgical treatment of the thyroglossal tract. Ann Surg 71:121–122PubMedCrossRefGoogle Scholar
  17. 17.
    Sistrunk WE (1928) Technique of removal of cysts and sinuses of the thyroglossal duct. Surg Gynecol Obstet 46:109–112Google Scholar
  18. 18.
    Hsieh YY, Hsueh S, Hsueh C, Lin JN, Luo CC, Lai JY, Huang CS (2003) Pathological analysis of congenital cervical cysts in children: 20 years of experience at Chang Gung Memorial Hospital. Chang Gung Med J 26:107–113PubMedGoogle Scholar
  19. 19.
    Tunkel DE, Domenech EE (1998) Radioisotope scanning of the thyroid gland prior to thyroglossal duct cyst excision. Arch Otolaryngol Head Neck Surg 124:597–599PubMedGoogle Scholar
  20. 20.
    Türkyilmaz Z, Sönmez K, Karabulut R, Demirgoullari B, Sezer C, Basaklar AC, Kale N (2004) Management of thyroglossal duct cysts in children. Pediatr Int 46:77–80PubMedCrossRefGoogle Scholar
  21. 21.
    Prasad KC, Dannana NK, Prasad SC (2006) Thyroglossal duct cyst: an unusual presentation. Ear Nose Throat J 85:454–456PubMedGoogle Scholar
  22. 22.
    Brousseau VJ, Solares CA, Xu M, Krakovitz P, Koltai PJ (2003) Thyroglossal duct cysts: presentation and management in children versus adults. Int J Pediatr Otorhinolaryngol 67:1285–1290PubMedCrossRefGoogle Scholar
  23. 23.
    Ostlie DJ, Burjonrappa SC, Snyder CL, Watts J, Murphy JP, Gittes GK, Andrews WA, Sharp RJ, Holcomb GW 3rd (2004) Thyroglossal duct infections and surgical outcomes. J Pediatr Surg 39:396–399PubMedCrossRefGoogle Scholar
  24. 24.
    Barnes L (1997) The ear. In: Silverberg SG, DeLellis RA, Frable WJ (eds) Priciples and practice of surgical pathology and cytopatholegy, 3rd edn. Churchill Livingstone, New York, pp 2839–2841Google Scholar
  25. 25.
    Kreft A, Hansen T, Kirkpatrick CJ (2005) Thyroid transcription factor 1 expression in cystic lesions of the neck: an immunohistochemical investigation of thyroglossal duct cysts, branchial cleft cysts and metastatic papillary thyroid cancer. Virchows Arch 447:9–11PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Itzhak Shvili
    • 1
  • Tuvia Hadar
    • 2
  • Rima Sadov
    • 1
  • Rumelia Koren
    • 3
    • 4
  • Jacob Shvero
    • 2
  1. 1.Department of Otolaryngology, Hasharon HospitalsRabin Medical CenterPetah TikvaIsrael
  2. 2.Departments of Otolaryngology, Beilinson HospitalsRabin Medical CenterPetah TikvaIsrael
  3. 3.Department of Pathology, Hasharon HospitalRabin Medical CenterPetah TikvaIsrael
  4. 4.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

Personalised recommendations