Surgical treatment for papillary cyst carcinoma thyroglossus

Abstract

Introduction: The thyroglossal cyst contains remnants of thyroid tissue that may give rise to a malignant neoplasm such as papillary carcinoma, which has been described in less than 1% of cases. This tissue originates at the base of the tongue in the foramen cecum, extending towards the anterior part of the neck. Materials and methods: A retrospective and descriptive study was conducted, including all patients diagnosed with a thyroglossal cyst and treated at the Oncology Institute and Hospital Bernardo Del Valle S. INCAN from January 2010 to December 2019. The study involved the analysis of epidemiological data, diagnostic methods, and surgical treatments. Results: The mean age at the time of diagnosis was 49.3 years. The most commonly requested study was ultrasound, conducted on 5 patients. When performing the fine-needle aspiration biopsy (FNAB), the Bethesda I result was common in 4 patients. The Sistrunk procedure was performed on 5 patients, and in 3 of those cases, an intraoperative frozen section study was not requested. Additionally, papillary carcinoma was reported in 1 patient, and in the final pathology, 4 cases of papillary carcinoma were diagnosed. Three patients underwent reoperation, resulting in a diagnosis of micropapillary carcinoma in one case and papillary carcinoma in another. The incidence at our institution was 57.1%. Conclusion: The approach to surgical management is based on the pathology report of the Sistrunk surgery, taking into account the associated risk factors for each patient. Total thyroidectomy is considered when there is a risk of malignancy, and this approach contributes to effective treatment. Sharing the therapeutic experiences applied in these cases contributes to offering optimal treatment options.