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Salih AM, Qaradakhy AJ, Saeed YA, Muhialdeen AS, Dhahir HM, Abdullah AM, Ahmed SF, Hassan SH, Rahim HM, Ali MBA, Abdalla BA, Hussein BO, Kakamad FH. Carcinoma arising from thyroglossal duct remnants. Biomed Rep 2024; 20:60. [PMID: 38414626 PMCID: PMC10895460 DOI: 10.3892/br.2024.1748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/11/2024] [Indexed: 02/29/2024] Open
Abstract
Thyroglossal duct cysts (TGDCs) are unusual remnants of the thyroid gland that are rarely observed in association with carcinoma. The present study aimed to showcase the clinical characteristics, diagnosis and management of patients with TGDC carcinoma. It was a single-center study conducted from February 2016 to February 2020. The study involved the retrospective analysis of a series of cases with TGDC carcinoma. A total of 10 patients were included in the study, of whom eight (80%) were females. Their age ranged from 25 to 48 years with a mean age of 39.1 years. A total of five cases (50%) underwent only Sistrunk's procedure, four patients (40%) underwent total thyroidectomy along with Sistrunk's procedure and one patient (10%) was treated by Sistrunk operation and lobectomy. In all of the cases (100%), histopathological examination confirmed papillary thyroid carcinoma in TGDCs. In addition, in the thyroid tissue, 2 cases (20%) also had papillary thyroid carcinoma and 3 cases (30%) had papillary thyroid microcarcinoma. Radioiodine was administered in one patient (10%) with suppressive thyroxine. A three-year follow-up with ultrasound revealed no suspicious lesions in any of the cases. Although rare, carcinoma may develop in the thyroglossal cysts. In this situation, both the thyroid gland and different lymph node compartments should be evaluated for malignancy. Surgical intervention is the cornerstone of management.
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Affiliation(s)
- Abdulwahid M Salih
- Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
| | - Aras J Qaradakhy
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Radiology, Shorsh Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
| | | | - Aso S Muhialdeen
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization, Sulaimani, Kurdistan 46001, Iraq
| | | | - Ari M Abdullah
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Pathology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
| | - Shaho F Ahmed
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
| | - Shko H Hassan
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
| | - Hawbash M Rahim
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization, Sulaimani, Kurdistan 46001, Iraq
- Department of Medical Laboratory Science, College of Health Sciences, University of Human Development, Sulaimani, Kurdistan 46001, Iraq
| | - Muhammed Bag A Ali
- Smart Health Tower-Raparin Branch, Raniyah, Sulaimani, Kurdistan 46001, Iraq
| | - Berun A Abdalla
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization, Sulaimani, Kurdistan 46001, Iraq
| | | | - Fahmi H Kakamad
- Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
- Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization, Sulaimani, Kurdistan 46001, Iraq
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2
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Dermawan JK, Chute DJ. Educational Case: Developmental Neck Masses and Other Neck Tumors. Acad Pathol 2019; 6:2374289519888735. [PMID: 31803826 PMCID: PMC6876162 DOI: 10.1177/2374289519888735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/21/2019] [Accepted: 10/12/2019] [Indexed: 11/17/2022] Open
Abstract
The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040.1
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Affiliation(s)
- Josephine Kamtai Dermawan
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Deborah J Chute
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
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3
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Das DK, George SA, Mohammad T, John B, George SS, Behbehani AI. Papillary carcinoma in thyroglossal duct cyst: Diagnosis by fine-needle aspiration cytology and immunocytochemistry. Diagn Cytopathol 2018; 46:797-800. [DOI: 10.1002/dc.23968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 04/24/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Dilip K. Das
- Department of Pathology, Faculty of Medicine; Kuwait University; Safat Kuwait
- Cytology Unit; Mubarak Al-Kabeer Hospital; Jabriya Kuwait
| | | | - Tareq Mohammad
- Histopathology Unit; Mubarak Al-Kabeer Hospital; Jabriya Kuwait
| | - Bency John
- Department of Pathology, Faculty of Medicine; Kuwait University; Safat Kuwait
| | - Sara S. George
- Department of Pathology, Faculty of Medicine; Kuwait University; Safat Kuwait
| | - Abdulla I. Behbehani
- Department of Pathology, Faculty of Medicine; Kuwait University; Safat Kuwait
- Department of Surgery; Mubarak Al-Kabeer Hospital; Jabriya Kuwait
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Sudharsanan S, Vijayakumar C, Dharanya S, Elamurugan TP, Manwar AS. A Rare Case of Carcinoma in the Thyroglossal Duct Cyst of an Elderly Patient. Cureus 2017; 9:e1365. [PMID: 28744412 PMCID: PMC5519316 DOI: 10.7759/cureus.1365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Thyroglossal duct cysts are the most common congenital abnormalities of the neck, constituting about 70% of all cervical neck masses in children and 7% of the adult population. The occurrence of carcinoma in a thyroglossal duct cyst is very rare (less than 1%). Malignancy of the thyroglossal duct cyst usually presents in the third or fourth decade of life. We report a case of carcinoma in the thyroglossal duct cyst, which presented for the first time in our elderly patient. A 76-year-old male presented with a 6 x 5 cm swelling in the anterior aspect of the neck. The swelling had been present for three months and had a variegated consistency. It moved with deglutition as well as with protrusion of the tongue. Intra-operatively, the lesion was cystic and was adherent to the hyoid bone. Sistrunk operation was done. The post-operative histopathology showed papillary carcinoma in the thyroglossal duct cyst. The standard treatment is Sistrunk procedure with close follow-up of the patient. Patients with metastatic disease require a total thyroidectomy and in the presence of neck secondaries, neck dissection has to be done. The diagnosis can be missed because of the rarity of this condition. Carcinoma should be suspected in a thyroglossal duct cyst when presenting for the first time in the elderly age group.
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Affiliation(s)
- Sundaramurthi Sudharsanan
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Chellappa Vijayakumar
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Srinivasan Dharanya
- Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - T P Elamurugan
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Ali S Manwar
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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5
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Choi YM, Kim TY, Song DE, Hong SJ, Jang EK, Jeon MJ, Han JM, Kim WG, Shong YK, Kim WB. Papillary thyroid carcinoma arising from a thyroglossal duct cyst: a single institution experience. Endocr J 2013; 60:665-70. [PMID: 23318645 DOI: 10.1507/endocrj.ej12-0366] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Thyroid cancers arising from a thyroglossal duct cyst (TGDC) are rarely reported. No clear consensus exists regarding optimal management. In this light, TGDC carcinomas recently treated at Asan Medical Center, as well as previously reported cases in the literature, were reviewed. There were ten patients who were diagnosed with TGDC carcinoma at our institution. All patients underwent pre-operative fine-needle aspiration biopsy (FNAB). Nine patients were suspected of having papillary carcinoma following cytology. The Sistrunk operation (SO) was performed in four patients, SO with total thyroidectomy (SO/TT) was performed in three patients, and SO/TT with neck dissection was performed in three patients. Six patients who received total thyroidectomy underwent radioactive iodine (RAI) therapy and T4 suppression. With a median follow-up period of 28.5 months, two patients showed recurrence and one of them died of the disease. We analyzed 163 cases from 1990 to 2012 with three or more cases TGDC carcinoma, including the present study. Among 48 patients who underwent FNAB, 75% had papillary thyroid carcinoma (PTC). SO, SO/TT, or SO/TT with neck dissection was performed in 27%, 41%, and 32% of patients, respectively. Among 119 patients who received total thyroidectomy, 36% had concomitant PTC in the thyroid. Among 52 patients who received neck dissection, 69% had cervical nodal involvement. The results of our review suggest that when TGDC carcinoma is suspected, ultrasonography and, if necessary, FNAB should be performed. If these tests reveal a suspected lesion in the thyroid or lymph node, SO/TT and lymph node dissection should be performed.
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Affiliation(s)
- Yun Mi Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
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Albayrak Y, Albayrak F, Kaya Z, Kabalar E, Aylu B. A case of papillary carcinoma in a thyroglossal cyst without a carcinoma in the thyroid gland. Diagn Cytopathol 2011; 39:38-41. [PMID: 21162091 DOI: 10.1002/dc.21356] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The thyroglossal duct cyst is the most common developmental anomaly of the thyroid gland. We present a patient with a papillary thyroid carcinoma diagnosed after surgical resection of a thyroglossal cyst. The 39-year-old patient reported to our hospital due to a swelling of this throat. The results of the ultrasonography were reported as showing multiple nodules in both thyroid lobes, and an ~3-cm diameter image in the submental area, in keeping with lymphadenomegalia. In the fine-needle aspiration cytology (FNAC) evaluation from the nodules in the thyroid, it was observed that the thyrocites with uniform nuclei made up single-layer groups. FNAC from the thyroglossal cyst, a few histiocytes were observed on a ground with a large number of erythrocytes. The patient was subjected to a total thyroidectomy, pyramidal lobe excision, and total excision of the 3-cm diameter soft mass, starting at the tip of the pyramidal lobe. The case was diagnosed as papillary thyroid carcinoma in thyroglossal duct cyst with histopathological and immunohistochemical findings. If the thyroglossal channel cyst had been diagnosed preoperatively, total thyroidectomy and a Sistrunk operation would have been performed. For this reason, repeated FNAC, particularly, if performed under ultrasound guidance, may improve the diagnostic value of FNAC. Thus, in such patients, throat ultrasonography must be carried out in expert hands, thin-needle aspiration biopsy, computerized tomography, and thyroid scintigraphy must be done if necessary, and the necessary treatment protocols carried out after a definite diagnosis.
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Affiliation(s)
- Yavuz Albayrak
- Department of General Surgery and Burn Unit, Erzurum Region Education and Research Hospital, Erzurum, Turkey.
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Kaneko C, Kato K, Kobayashi TK, Sakamoto H. Significance of intranuclear cytoplasmic inclusions in malignant pleural effusion. Diagn Cytopathol 2008; 36:531-3. [DOI: 10.1002/dc.20848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Falconieri G, Della Libera D, Zanella M. Papillary thyroid carcinoma of the thyroglossal duct cyst: comparative cytohistologic and immunochemical study of 2 new cases and review of the literature. Int J Surg Pathol 2001; 9:65-71. [PMID: 11469350 DOI: 10.1177/106689690100900114] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report a cytohistologic and immunohistochemical study of 2 cases of papillary thyroid carcinoma occurring in a thyroglossal duct cyst. The patients were a 21-year-old woman and a 48-year-old man. Needle aspiration cytology smears were consistent with papillary thyroid carcinoma. The Sistrunk procedure was done. Papillary carcinoma was found within a thyroglossal duct cyst. In 1 case, the tumor spread outside the cyst. Follow-up was uneventful in both patients (2 and 9 years, respectively). Our results would indicate that papillary carcinoma of thyroglossal duct cyst, though indistinguishable from its thyroid homologue, has a more indolent course and could therefore be singled out as a clinicopathologic entity. Needle aspiration cytology reliably assists in planning patient management.
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Affiliation(s)
- G Falconieri
- Division of Anatomic Pathology, City Hospital, Conegliano TV, Italy
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Yang YJ, Haghir S, Wanamaker JR, Powers CN. Diagnosis of papillary carcinoma in a thyroglossal duct cyst by fine-needle aspiration biopsy. Arch Pathol Lab Med 2000; 124:139-42. [PMID: 10629147 DOI: 10.5858/2000-124-0139-dopcia] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The incidence of papillary thyroid carcinoma arising in a thyroglossal duct cyst is rare and occurs in about 1 % of thyroglossal duct cysts. Only 17 such cases diagnosed with fine-needle aspiration biopsy have been previously reported in the English-language literature, with a diagnostic rate of 53%. In this article, the cytologic features of the current case are emphasized and those of the previous reported cases are briefly reviewed. Diagnostic pitfalls of papillary carcinoma arising in thyroglossal duct cysts diagnosed by fine-needle aspiration biopsy are also discussed.
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Affiliation(s)
- Y J Yang
- Departments of Pathology, SUNY Health Science Center at Syracuse, Syracuse, NY 13210, USA
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Mulhall KJ, O'Hanlon DM, Mortimer G, Quill DS. Papillary carcinoma in a thyroglossal duct remnant--a review of thyroglossal surgery in a regional centre in the west of Ireland. Ir J Med Sci 1998; 167:212-5. [PMID: 9868856 DOI: 10.1007/bf02937414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A review of thyroglossal duct remnants presenting to a regional centre in the West of Ireland was undertaken. Over a 15 yr period, 25 patients were operated on for duct remnants. The mean age was 19.6 yr and ranged from 3 to 68 yr. There were 16 (64 per cent) males and 9 (36 per cent) females. Seventeen (68 per cent) patients were less than 20 years at the time of surgery. Four patients presented with a sinus and the remainder with a cystic lesion. Two patients experienced recurrent disease. One patient, a 41 yr old female, had a papillary carcinoma of a thyroglossal cyst. There were no clinical features distinguishing this patient from those with benign cystic remnants of the thyroglossal duct. The possibility of carcinoma in older patients, in particular females, presenting with thyroglossal cysts emphasises the importance of performing a formal Sistrunk's operation. It reduces the risk of recurrence of the cyst and may reduce the risk of recurrence of the tumour as the duct may provide a route for the spread of tumour.
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Affiliation(s)
- K J Mulhall
- Department of Surgery, University College Hospital, Galway, Ireland
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Heshmati HM, Fatourechi V, van Heerden JA, Hay ID, Goellner JR. Thyroglossal duct carcinoma: report of 12 cases. Mayo Clin Proc 1997; 72:315-9. [PMID: 9121176 DOI: 10.4065/72.4.315] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To report the relative frequency, natural history, and optimal treatment of thyroglossal duct (TGD) carcinoma. DESIGN We retrospectively reviewed all cases of TGD carcinoma surgically treated during a 44-year period at a tertiary referral center. MATERIAL AND METHODS The computerized medical records database at Mayo Clinic Rochester was searched for patients who had the diagnosis of TGD carcinoma or TGD cyst carcinoma from 1950 through 1994. Medical records and pathologic specimens of these patients were reviewed. RESULTS Twelve patients (six male and six female patients), who were 17 to 60 years old (mean, 40), were identified. The frequency of TGD carcinoma among surgically removed TGD cysts was 0.7%. A midline upper neck mass was the initial symptom in all patients. The diagnosis of cancer was made after the Sistrunk procedure in 11 of 12 cases and preoperatively (by fine-needle aspiration biopsy) in only 1 case. All patients had papillary carcinoma. Thyroid involvement was noted in three cases. Nine patients had subtotal or near-total thyroidectomy, and three received postoperative radioactive iodine. After a mean follow-up of 13 years (range, 1 to 38), no patient had a documented local recurrence or distant metastatic involvement, and no tumor-associated mortality was observed. CONCLUSION TGD carcinoma is a rare malignant tumor that is usually diagnosed postoperatively. Papillary carcinoma is the most common pathologic finding. The recommended treatment is the Sistrunk procedure followed by near-total or total thyroidectomy by a skilled thyroid surgeon because of the possibility of intrathyroidal foci of cancer. The prognosis is excellent in patients with papillary tumor.
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Affiliation(s)
- H M Heshmati
- Division of Endocrinology, Metabolism, Nutrition and Internal Medicine, Mayo Clinic Rochester, MN 55905, USA
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