Thyroglossal Duct Cysts in the Adult Population: A Retrospective Analysis of Clinical Characteristics and Outcomes.

Background Thyroglossal duct cysts (TGDCs) represent the most common congenital midline neck mass; however, their presentation in adults is uncommon and often underreported. Adult cases may differ clinically from pediatric cases in symptomatology, diagnostic pathways, and risk of associated malignancy. This study contributes to the limited literature describing TGDCs in adults and highlights the importance of documenting their presentation and outcomes in this age group. Objective  To describe the demographic, clinical, surgical, and histopathological characteristics of adult patients with TGDCs treated in a tertiary care center and to evaluate postoperative outcomes following the Sistrunk procedure. Methods  A retrospective observational study was conducted including all adult patients aged ≥18 years who underwent surgical management for TGDC between May 2017 and November 2025 at the General Surgery Service of Hospital Civil de Guadalajara "Dr. Juan I. Menchaca." Variables analyzed included demographics, clinical features, preoperative imaging, surgical technique, intraoperative findings, histopathological results, and postoperative evolution. All patients were treated with the standard Sistrunk procedure. Descriptive statistics were obtained using IBM SPSS v27. The mean follow-up duration was 2 months. Results  Nine patients met the inclusion criteria (n=9). The cohort consisted of females (n=5, 55.6%) and males (n=4, 44.4%), with most individuals aged 40-60 years (n=5, 55.6%). Comorbidities were present in 3 patients (33.3%), including papillary thyroid carcinoma (n=1, 11.1%), hypothyroidism (n=1, 11.1%), and hypertension (n=1, 11.1%). All patients presented with a midline neck mass (n=9, 100%), and 3 patients (33.3%) reported intermittent enlargement and regression. The Sistrunk procedure was performed in all cases (n=9, 100%) without intraoperative or immediate postoperative complications (n=0, 0%). The mean cyst diameter was 3.4 cm (range: 1.2-5.6 cm). Histopathology identified ectopic thyroid tissue in 2 patients (22.2%), while no cases demonstrated malignancy (n=0, 0%). No patient developed postoperative hypothyroidism (n=0, 0%), and no recurrence was observed during the study period. Conclusion  TGDCs in adults exhibit a broad age distribution, underscoring the importance of maintaining diagnostic suspicion even beyond childhood. The Sistrunk procedure remains a safe and effective treatment in adults, with excellent outcomes. Documentation of TGDCs in adult populations is essential to better characterize their behavior, refine diagnostic approaches, and assess the true prevalence of associated comorbidities or malignancy in this underrepresented group.