Squamous Cell Carcinoma of a Thyroglossal Duct Cyst and the Role of a Level IA Neck Dissection

Abstract

Squamous cell carcinoma of a thyroglossal duct cyst is exceedingly rare, with less than 30 cases reported across the literature. Herein, we present a case of squamous cell carcinoma (SCC) of a thyroglossal duct cyst (TGDC) and discuss the utility of a level IA neck dissection in these cases. In 2018, a 62-year-old female presented to a university-affiliated otolaryngologist with symptoms of dysphagia and a palpable anterior midline neck mass. MRI demonstrated a 3.1 × 2.0-cm mass concerning an invasive TGDC. She was referred to our institution for further management. Preoperative imaging demonstrated an invasive TGDC but no pathological nodes. A Sistrunk procedure and a IA neck dissection were performed. Pathology demonstrated one pathological node in the neck dissection specimen. In summary, a bilateral IA neck dissection was performed on a clinically node zero (N0) patient, and a pathological node was ultimately identified. We hope that by introducing this idea of a IA neck dissection for SCC of a TGDC, we can prompt further investigation into the utility of this procedure for these uniquely rare cases.

Evidence and controversies in management of thyroglossal duct cyst carcinoma

“…When dealing with TGDCCa SCC, due to its worse prognosis and more aggressive behaviour [5], central compartment and level IA dissection may be helpful to better stage the disease and possibly indicate the need for adjuvant radiotherapy on the lateral neck levels [31].…”