Objective: To describe the clinical and paraclinical characteristics of lingual thyroglossal duct cysts in patients treated at the National Otorhinolaryngology Hospital of Vietnam.
Methods: This descriptive case series included 27 patients who underwent intraoperative biopsy and had histopathologically confirmed lingual thyroglossal duct cysts at the National Otorhinolaryngology Hospital of Vietnam between September 2022 and July 2025. Data were collected from medical records, otorhinolaryngologic endoscopic examinations, magnetic resonance imaging (MRI), and anterior neck ultrasonography. Study variables included demographic characteristics, medical history, clinical symptoms, endoscopic findings, and imaging features of the lesions.
Results: The median age was 26 years (range, 6–66 years), and 77.8% of patients were male. The most common symptom was a foreign-body sensation during swallowing (81.5%), while 18.5% of patients were asymptomatic. Endoscopy showed a solitary cystic lesion in all patients; 63.0% were located in the midline, 77.8% had a dome-shaped appearance, 81.5% had a smooth surface, and 77.8% were pale pink. On MRI, all lesions demonstrated the surrounding tongue-base muscle sign, while the beak sign was observed in 70.4%. Lesions measuring 20–30 mm accounted for 55.6% of cases, and epiglottic displacement was observed in 74.1%. All lesions were well circumscribed, without infiltration of adjacent tissues or solid components; 96.3% were hypointense on T1-weighted images, and 100% were hyperintense on T2-weighted images. On ultrasonography, the thyroid gland was in its normal anatomical position in all examined patients (21/21); 95.2% of lesions were hypoechoic, and all had well-defined margins.
Conclusion: In this study, lingual thyroglossal duct cysts occurred predominantly in young male patients, with a foreign-body sensation during swallowing being the most common clinical presentation. The main endoscopic and MRI features included a solitary cystic lesion at the tongue base, a midline location, the surrounding tongue-base muscle sign, low signal intensity on T1-weighted images, and high signal intensity on T2-weighted images.