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DR. MANEL BARDAJIDR. MANEL BARDAJI
Bardají Bofill ManelCirugía General Adultos
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Cysts associated with glandular structures

What are they?

These cysts, sometimes acquired and sometimes of congenital origin, are lesions with their own characteristics, associated with endocrinological glands such as the thyroid, parathyroid and thymus, and those associated with salivary glands. Its correct diagnosis will allow its adequate surgical treatment.

  • Thyroid cysts

    In the lower part of the neck we can find nodular formations with special characteristics, such as thyroid cysts, our objective will be on the one hand to recognize its relationship with this endocrine gland and on the other to achieve a differential diagnosis with thyroid neoplasms. We have a series of precise examinations to reach a correct diagnosis: ultrasound associated with fine needle puncture, computerized axial tomography (CT), thyroid scintigraphy and hormonal analytical tests.

    Any palpable increase in the size of the thyroid gland makes us consider the following situations, a marked and homogeneous increase with or without uptake in the ganmagraphy is common in young women and is not considered pathological. However, a marked and diffuse ganmagraphic uptake in a non-cystite gland. We must complete the exploration with a fine needle aspiration puncture, which will inform us of cuboid epithelial cells characteristic of the cyst wall, and the computerized axial tomography that will define their relationships and the presence of accompanying lymphadenopathy guides us towards a hyperthyroidism type Graves. If we find a hard and hypocaptant fixed nodule we will think of thyroid neoplasia, if this nodule is hypercaptive, and with mystical characteristics in ultrasound, the chances of malignant lesion are lower pointing to a toxic adenoma, and finally the presence of multiple hypercaptive lesions or captive areas and cold areas (old intracystic hemorrhages) translates the presence of a multicystic thyroid, In these cases the frequency of malignancy is lower, and the surgical indication arises for compressive or aesthetic reasons. Thyroid surgery will depend on the cyst and can be performed from an enucleation (rare), a hemithyroidectomy, a subtotal or total thyroidectomy.

    Quistes tiroideosQuistes tiroideoswhich occupies the entire left thyroid lobe, compresses the trachea and esophagus (which introduces into the posterior wall of the trachea), its lower prolongation was introduced in mediastinum, precise left hemithyroidectomy

  • Parathyroid cysts

    They are a rarity, and are characterized by being clinically like thyroid nodules, however when performing an aspiration puncture, it is common to obtain in the fluid of the cyst high levels of parathyroid hormone, this added to the fact that when performing a CT scan its independence from the thyroid gland is appreciated, in some cases it presents hyperparathyroidism, but this picture is more frequent in adenomas and cystadenomas. Treatment is surgical and the same considerations apply as in thyroid surgery.

    • Cutaneous bronchogenic cysts: Cutaneous bronchogenic cysts are very rare. They develop from ectopic cells of the respiratory tract, and are located at the level of the suprasternal fossa. They are slow growing and asymptomatic. Histologically they consist of a capsule covered with pseudostratified columellar ciliary epithelium containing mucous cells.
    • Thymic cysts: They are unilocular or multilocular cystic formations covered with squamous or cuboid epithelium, with clear or cloudy liquid content and usually unilateral. They proceed from the ectopic implantation of aberrant thymic cells. They are located along an imaginary line that joins the angle of the jaw with the central portion of the neck. They are usually asymptomatic, except when they become infected or grow rapidly.

    Quistes paratiroideosQuistes paratiroideosparathyroid cyst, was an adolescent patient with a lower suprasternal cystic lesion in relation to the thyroid lobe, on the primitive carotid and continued to the upper mediastinum

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