Persistent thyroglossal duct with a retrohyoid cyst containing pearl-like structures revealed by cadaveric dissection

Area of Science:

• Anatomy
• Embryology
• Surgical Pathology

Background:

• The thyroglossal duct (TGD) is an embryonic remnant crucial for thyroid gland development.
• Persistent TGDs can lead to thyroglossal duct cysts (TGDCs), but cadaveric reports are infrequent.
• The retrohyoid and infralingual spaces are less commonly recognized locations for TGDCs.

Purpose of the Study:

• To report a unique cadaveric finding of a persistent thyroglossal duct (TGD) with an associated cyst.
• To describe the anatomical course and characteristics of the identified thyroglossal duct cyst (TGDC).
• To emphasize the clinical and radiological significance of the retrohyoid space for occult TGDCs.

Main Methods:

• Routine dissection of the thyroid gland in an elderly female cadaver.
• Identification and anatomical tracing of a persistent thyroglossal duct (TGD).
• Midsagittal sectioning of the cervicocephalic region to delineate the TGD's course and cyst location.

Main Results:

• A persistent TGD was identified originating from the left thyroid lobe and extending superiorly.
• The TGD coursed posterior to the hyoid bone and inferior to the tongue, forming a multilocular thyroglossal duct cyst (TGDC).
• The TGDC contained nodular, pearl-like structures, a rare presentation.

Conclusions:

• This is the first cadaveric report of an intact persistent TGD with a retrohyoid/infralingual course and associated TGDC.
• The retrohyoid space should be considered a potential site for occult thyroglossal duct cysts (TGDCs).
• Targeted anatomical dissection is crucial for identifying these clinically silent and anatomically hidden TGDCs.