About Idiopathic Cervical Cyst of the Thoracic Duct: Case Report and Review of the Literature

Background: The supraclavicular cyst of the thoracic duct is a very rare entity with approximately 27 publications in the English literature. Our aim was to describe the clinical radiological and histological characteristics of this rare entity and to highlight its pathogenesis through the description of 2 cases diagnosed in our Department and a review of the literature. Materials and Methods: The authors describe 2 new cases of idiopathic supraclavicular cyst well documented by radiologic, macroscopic and microscopic findings. The review of the literature was performed through the pubmed site using the keywords: cervical thoracic duct cyst, thoracic duct cyst. Conclusion: We report 2 cases of idiopathic cervical thoracic duct cyst. We found about 27 thoracic duct cysts that have been reported in the English literature till now. Magnetic resonance imaging and chemical analysis of the fluid obtained by preoperative fine-needle aspiration seem to be sufficient to make a primary diagnosis but the final and positive diagnosis must be made based on microscopic findings. The mainstay treatment is represented by surgical resection. Some cases treated successfully by a direct puncture sclerotherapy or even spontaneous regression have been reported in the literature.