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<meta name="DC.Title" content="Enlargement and Transformation of Thyroglossal Duct Cysts in Response to Radiotherapy: Imaging Findings" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Thyroglossal duct cyst remnants (TGDC) are a common midline neck mass that is mostly encountered in childhood. Enlargement after an upper respiratory tract infection or, rarely, cancer within TGDC, is a well-documented phenomenon. In the pediatric population, it rarely presents a diagnostic quandary. However, in an adult population, especially one treated for head and neck cancer with radiation therapy (RT), any enlarging cystic mass would be concerning and would raise the specter of metastatic disease. We propose that inflammation associated with RT results in secretory stimulation and/or obstruction of a persistent thyroglossal duct, resulting in changes within a pre-existing TGDC.

MATERIALS AND METHODS: We present a case series of 8 patients with subclinical TGDC treated with RT for various head and neck cancers, in which we radiographically observed enlargement or cystic transformation (more cystlike appearance) of the cyst.

RESULTS: In all patients there was in retrospect a small thyroglossal remnant, though not necessarily a discernible cyst, that was observed after radiotherapy to enlarge and become more cyst-like.

CONCLUSIONS: In patients with pre-existing TGDC undergoing RT to the neck, enlargement and cystic transformation may be encountered radiographically and should not be misinterpreted as a tumor. Our series bolsters a recently reported description of the same phenomenon." />
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<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;b&gt;BACKGROUND AND PURPOSE:&lt;/b&gt; Thyroglossal duct cyst remnants (TGDC) are a common midline neck mass that is mostly encountered in childhood. Enlargement after an upper respiratory tract infection or, rarely, cancer within TGDC, is a well-documented phenomenon. In the pediatric population, it rarely presents a diagnostic quandary. However, in an adult population, especially one treated for head and neck cancer with radiation therapy (RT), any enlarging cystic mass would be concerning and would raise the specter of metastatic disease. We propose that inflammation associated with RT results in secretory stimulation and/or obstruction of a persistent thyroglossal duct, resulting in changes within a pre-existing TGDC.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MATERIALS AND METHODS:&lt;/b&gt; We present a case series of 8 patients with subclinical TGDC treated with RT for various head and neck cancers, in which we radiographically observed enlargement or cystic transformation (more cystlike appearance) of the cyst.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS:&lt;/b&gt; In all patients there was in retrospect a small thyroglossal remnant, though not necessarily a discernible cyst, that was observed after radiotherapy to enlarge and become more cyst-like.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSIONS:&lt;/b&gt; In patients with pre-existing TGDC undergoing RT to the neck, enlargement and cystic transformation may be encountered radiographically and should not be misinterpreted as a tumor. Our series bolsters a recently reported description of the same phenomenon.&lt;/p&gt;" />
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MATERIALS AND METHODS: We present a case series of 8 patients with subclinical TGDC treated with RT for various head and neck cancers, in which we radiographically observed enlargement or cystic transformation (more cystlike appearance) of the cyst.

RESULTS: In all patients there was in retrospect a small thyroglossal remnant, though not necessarily a discernible cyst, that was observed after radiotherapy to enlarge and become more cyst-like.

CONCLUSIONS: In patients with pre-existing TGDC undergoing RT to the neck, enlargement and cystic transformation may be encountered radiographically and should not be misinterpreted as a tumor. Our series bolsters a recently reported description of the same phenomenon." />
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MATERIALS AND METHODS: We present a case series of 8 patients with subclinical TGDC treated with RT for various head and neck cancers, in which we radiographically observed enlargement or cystic transformation (more cystlike appearance) of the cyst.

RESULTS: In all patients there was in retrospect a small thyroglossal remnant, though not necessarily a discernible cyst, that was observed after radiotherapy to enlarge and become more cyst-like.

CONCLUSIONS: In patients with pre-existing TGDC undergoing RT to the neck, enlargement and cystic transformation may be encountered radiographically and should not be misinterpreted as a tumor. Our series bolsters a recently reported description of the same phenomenon." />
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      <h1 class="highwire-cite-title" id="page-title">Enlargement and Transformation of Thyroglossal Duct Cysts in Response to Radiotherapy: Imaging Findings</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S. Singh</span>, <span class="highwire-citation-author" data-delta="1">D.I. Rosenthal</span> and <span class="highwire-citation-author" data-delta="2">L.E. Ginsberg</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">April 2009,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">30 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">800-802; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A1448 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-7663--6783282384" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S. Singh </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BSingh%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Singh%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.%2BSingh%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">D.I. Rosenthal </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.I.%2BRosenthal%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rosenthal%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.I.%2BRosenthal%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">L.E. Ginsberg </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.E.%2BGinsberg%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ginsberg%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AL.E.%2BGinsberg%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list"><li><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1 in text" id="ref-1">↵</a><div class="cit ref-cit ref-other" id="cit-30.4.800.1" data-doi="10.1148/radiographics.19.1.g99ja06121"><div class="cit-metadata"><cite>Koeller KK, Alamo L, Adair CF, et al. <strong>From the Archives of the AFIP: congenital cystic masses of the neck: radiologic-pathologic correlation</strong> [published erratum appears in <em>Radiographics</em> 1999;19:283]. <span class="cit-source">Radiographics</span> <span class="cit-pub-date">1999</span>;<span class="cit-vol">19</span>:<span class="cit-fpage">121</span>–46; quiz 152–53</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1148/radiographics.19.1.g99ja06121&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=9925396&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F4%2F800.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000078106700013&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2 in text" id="ref-2">↵</a><div class="cit ref-cit ref-other" id="cit-30.4.800.2"><div class="cit-metadata"><cite>Reede DL, Bergeron RT, Som PM. <strong>CT of thyroglossal duct cysts.</strong> <span class="cit-source">Radiology</span> <span class="cit-pub-date">1985</span>;<span class="cit-vol">157</span>:<span class="cit-fpage">121</span>–25</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=4034956&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F4%2F800.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=A1985AQV2100024&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3 in text" id="ref-3">↵</a><div class="cit ref-cit ref-other" id="cit-30.4.800.3"><div class="cit-metadata"><cite>Srinivasan A, Hayes M, Chepeha D, et al. <strong>Rare presentation of thyroglossal duct cyst after radiation therapy to the neck.</strong> <span class="cit-source">Australas Radiol</span> <span class="cit-pub-date">2007</span>;<span class="cit-vol">51</span>  Suppl:<span class="cit-fpage">B180</span>–82</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=17991058&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F4%2F800.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4 in text" id="ref-4">↵</a><div class="cit ref-cit ref-other" id="cit-30.4.800.4"><div class="cit-metadata"><cite>Patten B. <span class="cit-source">Human Embryology.</span> 3rd ed. New York: McGraw-Hill;<span class="cit-pub-date">1968</span> :<span class="cit-fpage">441</span>–42</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-5-1" title="View reference 5 in text" id="ref-5">↵</a><div class="cit ref-cit ref-other" id="cit-30.4.800.5" data-doi="10.1002/lary.5540870512"><div class="cit-metadata"><cite>Ellis P, van Nostrand AW. <strong>The applied anatomy of thyroglossal tract remnants.</strong> <span class="cit-source">Laryngoscope</span> <span class="cit-pub-date">1977</span>;<span class="cit-vol">87</span>:<span class="cit-fpage">765</span>–70</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1002/lary.5540870512&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=850454&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F4%2F800.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=A1977DE89700012&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-6-1" title="View reference 6 in text" id="ref-6">↵</a><div class="cit ref-cit ref-other" id="cit-30.4.800.6"><div class="cit-metadata"><cite>Kurt A, Ortug C, Aydar Y, et al. <strong>An incidence study of thyroglossal duct cysts in adults.</strong> <span class="cit-source">Saudi Med J</span> <span class="cit-pub-date">2007</span>;<span class="cit-vol">28</span>:<span class="cit-fpage">593</span>–97</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=17457484&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F4%2F800.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-7-1" title="View reference 7 in text" id="ref-7">↵</a><div class="cit ref-cit ref-other" id="cit-30.4.800.7"><div class="cit-metadata"><cite>Slotnick D, Som PM, Giebfried J, et al. <strong>Thyroglossal duct cysts that mimic laryngeal masses.</strong> <span class="cit-source">Laryngoscope</span> <span class="cit-pub-date">1987</span>;<span class="cit-vol">97</span>:<span class="cit-fpage">742</span>–45</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=3586819&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F4%2F800.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-8-1" title="View reference 8 in text" id="ref-8">↵</a><div class="cit ref-cit ref-other" id="cit-30.4.800.8"><div class="cit-metadata"><cite>Wunderbaldinger, P, Harisinghani MG, Hahn PF, et al. <strong>Cystic lymph node metastases in papillary thyroid carcinoma.</strong> <span class="cit-source">AJR Am J Roentgenol</span> <span class="cit-pub-date">2002</span>;<span class="cit-vol">178</span>:<span class="cit-fpage">693</span>–97</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=11856700&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F4%2F800.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000174055400028&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-9-1" title="View reference 9 in text" id="ref-9">↵</a><div class="cit ref-cit ref-other" id="cit-30.4.800.9" data-doi="10.1002/hed.20381"><div class="cit-metadata"><cite>Goldenber D, Scuibba J, Koch WM. <strong>Cystic metastasis from head and neck squamous cell cancer: a distinct disease variant?</strong> <span class="cit-source">Head Neck</span> <span class="cit-pub-date">2006</span>;<span class="cit-vol">28</span>:<span class="cit-fpage">633</span>–38</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1002/hed.20381&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=16477605&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F4%2F800.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li></ol></div></div>  </div>

  
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