Incidental thyroid papillary carcinoma in a thyroglossal duct cyst – management dilemmas

“…Literature is divided on this issue, however, broad guidelines indicate that total thyroidectomy should be done based on risk stratification. High-risk factors include age >45 years, male, size >4 cm, extra-capsular invasion, positive nodal status, history of irradiation, presence of cold nodules in thyroid on thyroid scan [8,20,21]. In such high-risk cases, Sistrunk's surgery with total thyroidectomy and modified neck dissection should be done if neck nodes are present.…”

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confidence: 99%

Papillary carcinoma thyroid in a thyroglossal cyst: A management dilemma

Verma

Patro

Damodharan

et al. 2017

Acta Oto-Laryngologica Case Reports

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Thyroglossal duct remnants can harbour malignant changes in them and can present as thyroglossal cysts which are picked up incidentally in postoperative histopathology. Management of these thyroglossal duct carcinomas has always been a controversy to decide on the need to perform a total thyroidectomy in these patients and the adjuvant treatment that's required. We present a case of a 48-year-old female patient of thyroglossal duct cyst carcinoma who had to be taken for total thyroidectomy and radio iodine ablation during treatment of the lesion. Careful treatment planning aids are necessary in the management of such lesions. ARTICLE HISTORY

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“…The standard treatment for a TGDC is Sistrunk procedure: resection of the duct to the base of the tongue and the central portion of the hyoid bone (15). When lymph node metastases are detected pre-operatively, a total thyroidectomy and regional neck dissection are recommended in addition to the Sistrunk procedure for TGD-associated PTCs (15).…”

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confidence: 99%

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confidence: 99%

“…When lymph node metastases are detected pre-operatively, a total thyroidectomy and regional neck dissection are recommended in addition to the Sistrunk procedure for TGD-associated PTCs (15). Suppressive hormone therapy and radioactive iodine are recommended for these patients (15). However, according to some researchers, ultrasound screening of the thyroid might be a reasonable option for surveillance of the patients with only small TGDC-associated PTCs without lymph node involvement, instead of total thyroidectomy.…”

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Metastatic Papillary Thyroid Carcinoma Arising from Thyroglossal Duct Cysts

Cerit

İyidir

Özkan

et al. 2016

AACE Clinical Case Reports

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Objective: We report a rare case of a patient who developed papillary thyroid carcinoma (PTC) arising from thyroglossal duct cysts (TGDCs) with lateral lymph node metastasis who had a normal thyroid gland and benign central compartment lymph nodes.Methods: We present a case with metastatic PTC arising from TGDC together with a brief review of the relevant literature.Results: A 38-year-old man patient was admitted with a cystic lesion in the midline of his neck. There was also an easily palpable lymph node on the left neck, which was suspected of being metastatic PTC on ultrasonography (USG). There was no nodule in the thyroid gland. A fineneedle aspiration cytology of the lymph node was positive for metastases of PTC. We performed an excision of the cystic lesion and total thyroidectomy with the central and left neck lymph node dissection. The cystic lesion pathology was reported as PTC, 10 mm in size. There was a metastatic lymph node in the lateral left neck compartment (regions III-IV), 7 cm in diameter, without central lymph node involvement. Radioactive iodine ablation therapy with 150 mCi of 131 I was given after the surgery. The patient is in remission for PTC 2 years after his surgery, and he is currently receiving levothyroxine suppression therapy.Conclusion: While evaluating a TGDC, a detailed neck USG should be performed in all cases. Furthermore, a biopsy should be conducted of suspected lymph nodes before planning the surgery. (AACE Clinical Case Rep. 2016;2:e325-e328) Abbreviations: DTC = differentiated thyroid cancer; FNA = fine-needle aspiration; MRI = magnetic resonance imaging; PTC = papillary thyroid carcinoma; RAI = radioactive iodine ablation; TGD = thyroglossal duct; TGDC = thyroglossal duct cyst; USG = ultrasonography INTRODUCTION

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Incidental thyroid papillary carcinoma in a thyroglossal duct cyst – management dilemmas

Abstract: The occurrence of incidental TPC in a TDC is rare. Though Sistrunk's procedure is adequate treatment for TDC, based on low, moderate, and high risk stratification, recommendations for further management of incidental TPC in TDC is discussed.

Cited by 36 publications

References 19 publications

Incidental papillary thyroid carcinoma in thyroglossal duct cyst case report

Incidental papillary thyroid carcinoma in thyroglossal duct cyst case report

Papillary carcinoma thyroid in a thyroglossal cyst: A management dilemma

Metastatic Papillary Thyroid Carcinoma Arising from Thyroglossal Duct Cysts

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