Thyroglossal Duct Cyst Carcinomas: A Clinicopathologic Series of 22 Cases with Staging Recommendations

Abstract

Carcinomas arising from thyroglossal duct remnant cysts (TGDCs) are rare, without well-defined management and staging criteria. All TGDCs (n = 685) diagnosed between 2005 and 2015 were retrospectively reviewed, with 22 carcinomas identified (3.2 % incidence). Twenty-two patients (17 females, 5 males), aged 12-64 years (mean 39.9 years; median 39 years) were identified. An anterior, superior midline neck mass was the presenting symptom in all patients. A cancer diagnosis [all papillary thyroid carcinoma (PTC)] was made after the Sistrunk procedure (SP), with a Bethesda Category V or VI classification preoperatively by fine needle aspiration in 5 of 12 cases tested. A SP was performed in all patients, with total thyroidectomy concurrently (n = 4) or subsequently (n = 12). A selected neck dissection was performed in 5 patients, with metastases found in 3. Of the patients who had a thyroidectomy, syn-

3 Cases of Papillary Thyroid Carcinoma within Thyroglossal Duct Cyst – 1 Pediatric and 2 Adult Patient’s

“…According to our experience, 4% of thyroglossal duct cysts were found to contain thyroglossal cyst carcinoma. TGDCCa affect women more frequently than men with a 2.3:1 female to male ratio observed in the literature [3]. All our three cases were female.…”

“…The true incidence of thyroglossal duct cyst carcinoma is difficult to define precisely. The reported incidence of carcinoma occurring in TGDCs ranges from 1 to 19.6% [3]. According to our experience, 4% of thyroglossal duct cysts were found to contain thyroglossal cyst carcinoma.…”

“…Preoperative FNAC were often used to aid diagnosis. However it had reported true positive rate of 53 % and a false negative rate of 47 % [3]. This is probably due to the cystic nature of thyroglossal cyst with poor cellular yield.…”

“…USG, CT or MRI occasionally showed suspicious features of carcinoma. The presence of solid components, calcifications, irregular/thick wall or invasions had been suggested as features of a carcinoma within a TGDC [3].…”

Thyroglossal Duct Cyst Carcinomas in Pediatric Patients: Report of Two Cases with a Comprehensive Literature Review

“…Rarely, TGDCs may harbor an associated carcinoma. The incidence of malignancy among TGDCs is difficult to define, though a recent large community practice based series suggests a frequency of approximately 3% [4]. TGDC carcinomas occur predominantly in adults, typically in the fourth decade of life [1,4].…”