Papillary carcinoma in a supra hyoid thyroglossal duct cyst — an unusual presentation

Abstract

Carcinomatous transformation of ectopic thyroid elements within the thyroglossal tract is a rare entity. We report a case of primary papillary carcinoma of thyroid presenting within the thyroglossal duct cyst in a 23 year old gentleman. The patient presented to us, as a case of suprahyoid thyroglossal cyst with sub-lingual involvement and he underwent surgical excision of the entire thyroglossal tract by Sistrunk's approach. The post-operative histopathological diagnosis was of a papillary carcinoma within the thyroglossal duct cyst. Hence, the patient was evaluated for a malignant focus in the thyroid which proved negative. He was counseled regarding the possibility of developing Carcinoma in the thyroid gland and offered two options of further management viz., total thyroidectomy followed by life long thyroid suppression or watchful observation and follow up. As the patient belonged to the low risk group, he opted for the second option. He is presently kept under meticulous follow up and remains asymptomatic till date. We present the pre-and post-operative imaging, intra-operative fi ndings, histo-pathological features and review the present world literature on this rare entity.

Thyroglossal Duct Cyst Carcinoma: A Systematic Review of Clinical Features and Outcomes

“…Ninety‐eight articles met the inclusion criteria and were included in the final analysis with a total population of 164 patients. Eighty‐one case reports and 17 case series were included 4–101 . The largest case series included 18 patients, and the studies that we evaluated spanned from 1986 to 2016.…”

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

“…Thyroglossal duct cyst is caused by incomplete degeneration and atresia and incomplete disappearance of the epithelium of the thyroglossal duct during embryonic development. It is the most common cause of midline neck swelling, and the incidence rate in the general adult population is ~0.5–3% ( 3 ). In 1891, His ( 4 ) was the first to report thyroglossal duct remnants progressing to thyroglossal duct cysts, and 1.5–45% of cases show ectopic thyroid tissue in the cyst ( 5 , 6 ).…”