Individual treatment strategy of thyroglossal duct cyst carcinoma: a case report

Abstract

Background: Neoplasia of ectopic thyroid components is relatively rare in thyroglossal duct cysts. We report a case of histopathologically confirmed papillary thyroid carcinoma in a thyroglossal duct cyst, discuss its clinical characteristics of, and provide reference for diagnosis and treatment.Case Description: We presented a 25-year-old female went to hospital because of "a tumor in her neck".She was preoperatively diagnosed with thyroglossal duct cyst by cervical ultrasound, and enhanced computed tomography (CT). However, the solid component of the mass suggested intracystic neoplasia. She underwent Sistrunk surgical resection, and postoperative histopathology showed thyroglossal duct cyst, and papillary thyroid carcinoma in the cyst wall. The patient had no high-risk factors and had a low risk of recurrence.After full disclosure, the patient chose close follow-up, and to date there has been no recurrence.Conclusions: There are controversies regarding the origin of thyroglossal duct cyst carcinoma and the extent of surgery required, and a lack of unified treatment guidelines. We recommend tailoring individualized treatment based on individual risk stratification. By reporting this case, we hope to inform surgeons of the various abnormalities that may occur in ectopic thyroid tissue.

Malignant degeneration of thyroglossal duct cysts: Clinical aspects, imaging findings and management: Case series

“…Authors supporting a limited intervention, such as the Sistrunk procedure, cite reasons such as the potential increase in morbidity associated with re-intervention, the low percentage of thyroid cancer found, the possibility of subsequent excision if cancer is discovered, and the generally favorable prognosis of thyroid cancer [ 9 , 21 ]. Immediate lymph node dissection is recommended when clinically or ultrasound-suspicious lymphadenopathy is present [ 1 , 3 , 9 , 11 ]. Following thyroidectomy, iodine-131 scintigraphy and thyroglobulin tests are performed.…”

“…Thyroglossal duct cysts (TDCs) are congenital cervical malformations resulting from the incomplete resorption of the tract connecting the base of the tongue to the thyroid isthmus. While these cysts are generally benign, neoplastic degeneration is a rare occurrence, affecting approximately 1 to 1.5 % of cases [ [1] , [2] , [3] ]. The first documented instance of cancerization within the TDC dates back to the early twentieth century, credited to Brentano, and since then, approximately 250 cases have been reported in the medical literature [ 3 , 4 ].…”

“…While these cysts are generally benign, neoplastic degeneration is a rare occurrence, affecting approximately 1 to 1.5 % of cases [ [1] , [2] , [3] ]. The first documented instance of cancerization within the TDC dates back to the early twentieth century, credited to Brentano, and since then, approximately 250 cases have been reported in the medical literature [ 3 , 4 ].…”