Congenital Pyriform Sinus Fistula Presenting as a Neck Mass or Acute Suppurative Thyoiditis in Children.

Abstract

Eight cases of pyriform sinus fistula (PSF) with acute suppurative thyroiditis and/or a neck abscess were retrospectively analyzed. We concluded the clinical characteristics of PSF are as follows: (a) onset in childhood, (b) left side predominance, (c) often recurrent, and (d) usually having developed into a neck mass after an episode of upper repiratory tract infection. The characteristics on esophagography of PSF included a sinus tract (a) arising from the tip of the apex of the pyriform sinus, (b) extending anteriorly and inferiorly at the anterior aspect of the sternocleidomastoid muscle, (c) often on the left side of the esophagus and trachea, and (d) ending at the superior aspect of the clavicle. The embryological basis and the clinical and diagnostic imaging features of PSF in the literature are also reviewed and presented in this report.