Thyroiditis revealing a rare congenital anomaly: about 3 cases

Malika El Omri; Jemli S; Bellakhdher Mouna; Meherzi Abir; Houas Jihene; Ghammem Monia; Ach Taieb; Kermani Wassim; Abdelkefi Mohamed

doi:10.1530/endoabs.99.EP884

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Endocrine Abstracts (2024) 99 EP884 | DOI: 10.1530/endoabs.99.EP884

ECE2024 Eposter Presentations Thyroid (198 abstracts)

Thyroiditis revealing a rare congenital anomaly: about 3 cases

El Omri Malika ¹ , Jemli S ¹ , Bellakhdher Mouna ¹ , Meherzi Abir ¹ , Houas Jihene ¹ , Ghammem Monia ¹ , Ach Taieb ² , Kermani Wassim ¹ & Abdelkefi Mohamed ¹

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¹ENT Department Farhat Hached Hospital, Sousse, Tunisia; ²Endocrinology Department Farhat Hached Hospital, Sousse, Tunisia

Introduction: Fourth branchial lesions are a rare cause of inflammatory neck masses in children. The aim is to emphasize the pathophysiology, clinical features, and therapeutic modalities of the fourth branchial cleft cyst. We report three cases of fourth branchial arch cysts complicated by superinfection, collected in our ENT and neck surgery department.

Results: There were three male children aged of 4, 6 and 18 years old respectively. They consulted our department foran acute basicervical swelling in one case and an isolated acute left cervical swelling in another case. The swelling was associated with torticollis in the third case. Physical Examination found a basicervical inflamed mass whose size varied between 4 and 8 cm. Cervical ultrasound showed a basicervical abscess pushing the homolateral thyroid lobe, hypopharyngoscopy suggested a piriform sinus fistula in two cases. Computed tomography scan revealed a left lateral thyroid cystic mass in one case. All our patients underwent intravenous antibiotics therapy. Surgical drainage of the abscess was required in two cases. In a later step, we performed chemical cauterization of the fistula within piriform sinus in two cases and hemithyroidectomy in three of them. Post-operative outcomes were favorable without any recurrence for the all the cases.

Conclusion: The fourth branchial cyst are unfrequent congenital anomalies occurring in 2% to 4%. This case highlights the significance of including congenital anomalies, especially rare etiologies, as a potential differential diagnosis when assessing pediatric neck masses.