“Incidental Papillary Thyroid Cancer in Thyroglossal Duct Cyst”: A Case Report

Document Type : Case Report

Authors

1 Head, Neck and Maxillofacial Surgery Service, Hospital Nacional Dos de Mayo, Lima-Perú, Universidad Nacional Mayor de San Marcos, Lima-Perú.

2 Head, Neck and Maxillofacial Service, Hospital Central Policía Nacional del Perú.

3 Head, Neck and Maxillofacial Service, Hospital Nacional de Salud del Niño, Breña.

Abstract

Introduction:
Papillary thyroid cancer (PTC) in thyroglossal duct cyst (TGDC) is an infrequent condition with less than two hundred cases described in literature, with an incidence likely to be close to 1%. While its management is quite straightforward, there exists significant controversy regarding whether additional treatment is needed to manage incidentally noticed carcinoma in TGDCs.
 
Case Report:
A 37-years-old man came to us complaining of a slowly progressive neck mass located in the midline from 4 years ago. Ultrasonography (US) showed a mixed tumor with cyst predominance of 90x79x50 mm and Computed-Tomography (CT) revealed a mixed inframentonian heterogeneous tumor associated with small, mostly peripheral calcifications. The mass was resected using Sistrunk’s surgery. Histologic review reported a moderately differentiated papillary carcinoma in thyroglossal duct cyst, without vascular and lymphatic invasion. After two months, a total thyroidectomy was done, to which the pathological report informed normal thyroid.
 
Conclusion:
Thyroglossal duct cyst carcinoma is a rare entity. Management should be decided on single risk stratification. In all cases, a Sistrunk surgery would be accomplished in order  to remove the tumor. The reason for thyroidectomy in individuals with a normal thyroid is due to the probability of presenting an intraglandular thyroid cancer concomitantly. It also enables the management with radio-iodine and patient follow up by quantifying thyroglobulin levels.

Keywords

References

  1. Patel S, Escrig M, Shaha A, Singh A, Shah J. Management of well-differentiated thyroid carcinoma presenting within a thyroglossal duct cyst. J Surg Oncol. 2002 Mar;79(3):134-139.
  2. Plaza C, López M, Carrasco C, Meseguer L, Perucho A.  Management of well-differentiated thyroglossal remnant thyroid carcinoma: time to close the debate? Report of five new cases and proposal of a definitive algorithm for treatment. Ann Surg Oncol. 2006 May;13(5):745-752.
  3. Agosto-Vargas Y, Gutiérrez M, Martinez J, Mangual-Garcia M, Palermo C, Vélez-Maymi S. Papillary Thyroid Carcinoma: Ectopic Malignancy versus Metastatic Disease. Case Rep Endocrinol. 2017;2017(1):1-3.
  4. Akram R, Wiltshire J, Wadsley J. Adult Thyroglossal Duct Carcinoma of Thyroid Epithelial Origin: A Retrospective Observational Study. Indian J Otolaryngol Head Neck Surg. 2016 Oct–Dec; 68(4):522–527.
  5. Rayess H, Monk I, Svider P, Gupta A, Raza N, Lin H. Thyroglossal Duct Cyst Carcinoma: A Systematic Review of Clinical Features and Outcomes. Otolaryngol Head Neck Surg. 2017 May; 156(5):794-802.
  6. Evans L, Park S, Elliot C, Garrett C. Ectopic Papillary Carcinoma in the Midline Neck Accompanied by a Benign Thyroid Gland. Case Rep Otolaryngol. 2019 Jan; 2019(1):1-3.
  7. Widstrom A, Magnusson P, Hallberg O, Hellqvist H, Riiber H. Adenocarcinoma originating in the thyroglossal duct. Ann Otol. 1976; 85(1):
    286–90.
Iranian Journal of Otorhinolaryngology
Volume 33, Issue 3
May and June 2021
Pages 187-190

Files

Share

How to cite

Statistics