Papillary Thyroid Carcinoma within Thyroglossal Duct Cyst: Case Series and Literature Review

Abstract

Introduction Thyroglossal duct cyst (TGDC) is the most common congenital anomaly of the neck, and approximately 7% of all the adult population presents it. Ectopic thyroid tissue is found in the thyroglossal duct cyst wall in up to 65% of cases. This thyroid tissue has the potential to develop some type of malignancy, the most common of which is the papillary carcinoma of the thyroid. There are just over 270 cases of thyroglossal duct cyst malignancy reported in the literature. Objectives We aimed to study our population of patients in order to identify cases with thyroglossal duct cyst malignancy. Methods A retrospective chart review was conducted in the section of otolaryngology/head and neck surgery at a hospital in Karachi, Pakistan, from January of 2004 to December of 2014 on patients with the diagnosis of thyroglossal duct cyst. Results Fifty-eight patients were diagnosed with TGDC, two of whom also presented with thyroglossal duct cyst carcinoma. Both patients revealed papillary thyroid carcinoma on histopathology. Case 1 had an open biopsy before undergoing definitive surgery. Both patients underwent subsequent total thyroidectomy after Sistrunk procedure, and case 2 had selective neck dissection revealing lymph node metastasis. Conclusion Thyroglossal duct cyst carcinoma is a rare finding that comes as a surprise to both the patient and the surgeon. We report 2 out of 58 cases diagnosed with thyroglossal duct cyst carcinoma.

Development of augmented‐reality applications in otolaryngology–head and neck surgery

“…Though the patient was asymptomatic and the mass could not be palpated on physical exam, the findings were felt to be consistent with a thyroglossal duct cyst (TDC). Surgical excision of these lesions is recommended due to their potential for growth, infection, and malignancy . The patient underwent a Sistrunk procedure.…”

Thyroglossal Duct Cyst Carcinoma in a Young Female: Case Report and Review of Literature

“…The role of preoperative fine-needle aspiration (FNA) is debated and has an only 53% diagnostic rate for detecting TGDC carcinoma though accuracy of diagnosis is improved by sampling the solid component if present [6]. Overall, TGDC malignancy is relatively uncommon with roughly 278 previously reported cases, the most common malignancy being papillary thyroid carcinoma in 75–80% of cases [4, 8]. Given the rarity, the optimal management is controversial.…”

Thyroglossal duct cyst papillary thyroid cancer – the state of the art

“…Typically, TDCC is a neck mass that is enlarging flexible midline or slightly lateral (95% situated on the left side), most often without other worrisome symptoms. Still, some patients suffer from neck pain, dysphagia or relapsing throat infections [3,[6][7][8]. The mass usually moves on swallowing.…”

“…Regional lymphadenopathy due to the lymph node metastases of thyroglossal duct cyst carcinoma occur in only 7.7-15.0% of all reported cases, and local invasion rarely exists. Distant metastases have been described in less than 2% of all cases [4,8].…”

“…In children, TDCs account for 70-75% of all midline neck tumors. Ectopic thyroid tissue may be localized in the thyroglossal duct remnants (in over 50-65% of all cysts), and in 1% of all patients, this is the only functioning thyroid tissue in the body [2,3,[6][7][8][9]. Most TDCs are benign tumors, however, 0.7-1.5% develop into carcinoma [10,11].…”