Papillary thyroid carcinoma arising from a thyroglossal duct cyst

Abstract

Thyroglossal duct cysts (TGDCs) are the most common form of congenital cysts on the neck. The incidence of papillary thyroid carcinoma in TGDC is less than 1%. In most cases, the diagnosis is made postoperatively. We present a case of 22-year-old female with papillary thyroid carcinoma arising from a TGDC, identified in pathologic study after Sistrunk operation. There was no clinical evidence of malignancy in the cyst. There was neither invasion to adjacent tissue nor lymph node involvement. The patient then underwent total thyroidectomy and bilateral neck dissection. The patient was treated with radioactive iodine and thyroid suppression therapy was given as adjuvant treatment. She has been followed-up for 2 years without any metastasis. Because of the rarity of TGDC, this diagnosis may be missed, drastically affecting the appropriateness of the treatment provided. Surgeons should be aware of TGDC in surgical planning and postoperative treatment and should include this pathology in differential diagnosis of anterior midline neck masses.

Locally Advanced Thyroglossal Duct Cyst Carcinoma Presenting as a Neck Mass

“…This thyroglossal tract usually disappears by 10th week of gestation [2, 5]. However, it fails to involute in 7% of cases [1, 4].…”

“…Malignancy should be suspected if the thyroglossal duct cyst is hard, irregular, fixed, rapidly growing, and associated with palpable neck lymph nodes [2, 4]. Ultrasonogram (US) and fine needle aspiration cytology (FNAC) of the cyst may help diagnose TDCC preoperatively [5].…”

“…Thyroglossal duct cyst is a developmental anomaly arising from the failure of thyroglossal duct to involute during embryological development [ 1 ]. It is the most common congenital anomaly of the neck [ 1 , 2 ] and is present in approximately 7% of the general population [ 1 , 3 ]. Uncommonly, thyroglossal duct cyst carcinoma (TDCC) may be found in 1% of cases, the majority being papillary carcinoma [ 2 , 4 ].…”

Tiroglossal duktus kistinde gelişen papiller tiroid karsinom

“…Tiroglossal duktus kistinden kaynaklanan papiller karsinom tedavisinde kist duvarını aşan tümör invazyonu veya servikal lenf nodlarına yayılım bulunmadığı, tiroid bezinin normal olduğu, tümör çapının 1 cm'den büyük olmadığı durumlarda Sistrunk işlemi ve postoperatif tiroid süpresyon tedavisi önerilmektedir (9). Bu kriterlere uymayan tümör varlığında, boyunda lenf nodu tutulumu veya kist duvarı invazyon durumunda tiroidektomi ile beraber modifiye radikal boyun diseksiyonu uygulanması gerekmektedir (10 …”

Squamous Cell Carcinoma of Thyroglossal Duct Cyst

“…Normally, the thyroglossal duct tract later solidifies and subsequently obliterates entirely by the fifth to tenth week of gestation. [5] Thyroglossal duct cyst is the most common benign cervical mass except for benign cervical lymphadenopathy. The incidence of carcinoma in thyroglossal duct cyst is very rare, the incidence of which is 1%.…”