Thyroglossal duct cyst (TGDC) is known to be the most common midline neck mass in children, but the adult population still has this abnormality. The most common symptom of TGDC is a simple neck mass, and differential diagnosis among other abnormalities is important. The aim of this study is to perform a retrospective view of TGDC in order to describe any differences in clinical features, diagnostic tools, treatment, and outcomes in children and adults who underwent surgery in a single institution, and to determine its clinical implications.

We performed a retrospective chart review on 75 pathologically diagnosed TGDC patients from 1995 to 2013 who were divided into two groups: children (≤18 years) and adults. Comparison analysis was performed for age, sex, site and location of cyst, size, diagnostic tool, surgical method, and postoperative outcome.

Our study showed frequent occurrence of TGDC in adults. There was no significant sex, site, or location difference in the occurrence of TGDC in children and adults, however, the size of cyst in adults was larger than that in children (mean, 2.80 cm vs 2.15 cm) (P<0.001). Four patients (5.3%) had postoperative recurrence of TGDC, and Sistrunk operation showed lower recurrence rate than excision (3.1% vs 18.2%) (P<0.040). Two malignancy cases were identified postoperatively in adults.

Particularly in adults, the possibility of carcinoma would make it important to perform fine-needle aspiration for differential diagnosis. Sistrunk procedure will remain the treatment of choice for most TGDC patients considering recurrence risk.