Thyroidal abscesses in third and fourth branchial anomalies: not only a paediatric diagnosis

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Schelto Kruijff1, Mark S Sywak1, Stan B Sidhu1

  • 1Endocrine Surgical Unit, The University of Sydney, Sydney, New South Wales, Australia.

ANZ Journal of Surgery
|March 29, 2014
PubMed

Insights

Thyroid abscesses and acute suppurative thyroiditis, often linked to branchial cleft anomalies, are not exclusive to children. This condition can affect adults, emphasizing the need for prompt diagnosis and treatment in all age groups.

Area of Science:

  • Otolaryngology
  • Endocrinology
  • Pediatric Surgery

Background:

  • Acute suppurative thyroiditis and recurrent abscesses are typically associated with third and fourth branchial anomalies in children.
  • However, these thyroid abscesses can also manifest in adults, often stemming from branchial cleft anomalies.
  • Delayed recognition and treatment of neck abscesses can lead to severe, life-threatening complications.

Purpose of the Study:

  • To investigate the occurrence and management of thyroid abscesses in relation to branchial cleft anomalies across different age groups.
  • To highlight that thyroid abscesses are not solely a pediatric diagnosis.

Main Methods:

  • A retrospective case series was conducted over a 12-month period (January-December 2012).
  • The study included patients with thyroid abscesses and branchial cleft anomalies from both adult and pediatric centers.
  • Data collected included demographics, clinical presentation, imaging, surgical management, histology, and outcomes.

Main Results:

  • Five patients were identified: one child (9 years) and four adults (20-41 years).
  • All patients presented with third or fourth left branchial cleft anomalies, leading to suppurative thyroiditis and left-sided thyroid abscesses.
  • Management varied, including abscess drainage, primary thyroid lobectomy, or delayed lobectomy after drainage.

Conclusions:

  • Acute suppurative thyroiditis and thyroid abscesses can occur at any age, not just in children.
  • Thyroid abscesses in both children and adults are almost invariably linked to underlying branchial cleft anomalies.
Abstract

Keywords:
acute suppurative thyroiditisthird and fourth branchial anomaliesthyroidal abscesses

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