What's up with my neck? Ultrasound and surgical findings in cervical midline tumors.

OBJECTIVE

Evaluate ultrasound (US) sensitivity and specificity in suspected thyroglossal duct cysts (TGDC) undergoing surgery in our hospital, and their correlation with surgical findings.

MATERIAL AND METHODS

Retrospective study of 150 patients undergoing surgery for midline neck mass suggestive of TGDC (2008-2018). We analyzed epidemiological variables and compared the correlation between diagnostic ultrasound imaging and surgical findings, considering previous episodes of local infection.

RESULTS

Mean age at surgery was 3.96 years (0.75-12.58 years). Of the 150 patients, 81 were male and 69 were female. Following ultrasound examination, 110 were suspected to have TGDC, and diagnosis was confirmed after surgery in 80 cases. Of the remaining 40 cases without TGDC-compatible US examination, TGDC was confirmed in 15 cases. The rest were diagnosed with dermoid cyst (49), lymphadenopathy (4), and vascular malformation (2). US sensitivity was 84%, while specificity was 45%, with a positive predictive value of 73%, and a negative predictive value of 62%. In 62.1% (59) of TGDCs, a previous infection episode had been described, with 16.7% of cases requiring surgical drainage. 13.6% had recurrence after Sistrunk technique. There was no statistically significant relationship between previous infection episodes and postsurgical recurrence, or between surgical or spontaneous drainage and cyst recurrence.

CONCLUSIONS

Even though US role in eutopic thyroid gland identification cannot be doubted, it provides with low specificity in the study of midline neck masses. Therefore, the physician's opinion should be prioritized.