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Mremi A, Nkya G, Amsi P, Sadiq A, Lodhia J, Pallangyo A. Papillary thyroid carcinoma arising from ectopic thyroid tissue in a neck branchial cyst. SAGE Open Med Case Rep 2023; 11:2050313X231168555. [PMID: 37122428 PMCID: PMC10134172 DOI: 10.1177/2050313x231168555] [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: 01/19/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023] Open
Abstract
A 35-year-old man presented with a right lateral neck mass for 6 years. Thyroid function test was within normal limits. Computed tomography scan of the neck was suggestive of branchial cyst, tuberculous lymphadenopathy and normal thyroid gland. Fine needle aspiration cytology of cervical lymph node was suggestive of metastatic carcinoma. Branchial cystectomy spearing the thyroid gland was undertaken. Histopathology analysis of the resected specimen confirmed it to be papillary thyroid carcinoma originating from ectopic thyroid tissue in a branchial cyst. The patient was scheduled for total thyroidectomy and neck dissection. Unfortunately, he was lost to follow-up. A brief review of the literature regarding this unusual presentation of thyroid cancer has been provided.
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Affiliation(s)
- Alex Mremi
- Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Alex Mremi, Department of Pathology, Kilimanjaro Christian Medical Centre, 3010 Moshi, Tanzania.
| | - Gilbert Nkya
- Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Patrick Amsi
- Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Adnan Sadiq
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Radiology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Jay Lodhia
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Angela Pallangyo
- Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Lukáš J, Drábek J, Lukáš D, Zemanová I, Rulseh A. Ectopic thyroid with benign and malignant findings: A case series. Int J Surg Case Rep 2019; 66:33-38. [PMID: 31790949 PMCID: PMC6909043 DOI: 10.1016/j.ijscr.2019.11.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/04/2019] [Accepted: 11/06/2019] [Indexed: 11/28/2022] Open
Abstract
Thyroid heterotopy can be a cause of tumorous oropharyngeal and neck lesions. We present three cases of ectopic thyroid tissue with compression of the upper aerodigestive tract in the lingual area, thyroglossal duct cyst, and right submandibular region. We describe clinical and imaging examinations for diagnosis and treatment.
Introduction Ectopia is the most common sporadically occurring thyroid heterotopy. We present three cases of ectopic thyroid tissue with compression of the upper aerodigestive tract. The first case involved ectopic thyroid tissue in the lingual area of a 60-year-old male with dysphagia, swelling at the base of the tongue, and stomatolalia. The second case was a 66-year-old female with papillary thyroid carcinoma (PTC) in a thyroglossal duct cyst. The third patient was a 50-year-old female with aberrant thyroid tissue in the right submandibular region, with a cribriform-morular variant of PTC (CMV-PTC). Methods After resecting the heterotopic tissue and verifying the presence of PTC, the second and third cases underwent total thyroidectomy, and the third patient also underwent radioactive iodine ablation (RAI). Postoperative athyreosis was compensated by permanent levothyroxine substitution. Results The diagnosis of ectopic thyroid tissue is challenging. Clinical examination together with imaging methods play a key role, especially postoperative histological examination along with scintigraphy and single photon emission computed tomography (SPECT). Ultrasonography should be used to exclude normally localized thyroid tissue and to distinguish other tumorous diseases. In the pre-operative examination, ultrasound-guided fine-needle aspiration biopsy (US-FNAB) often results in technically-difficult sampling and non-diagnostic cytology. Conclusion Resection is the most suitable therapy for clinical symptoms of a foreign body in the upper aerodigestive tract and inflammatory complications; total thyroidectomy follows in case of malignant transformation. Thyroid heterotopy is a rare pathological condition, yet it should be taken into consideration during differential diagnosis of tumorous oropharyngeal and neck lesions.
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Affiliation(s)
- J Lukáš
- Department of Otolaryngology and Head and Neck Surgery, Na Homolce Hospital, Prague, Czech Republic.
| | - J Drábek
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - D Lukáš
- Department of Surgery, 3rd Faculty of Medicine, Charles University and University Hospital in Prague, Czech Republic
| | - I Zemanová
- Department of Pathology, Na Homolce Hospital, Prague, Czech Republic
| | - A Rulseh
- Department of Radiology, Na Homolce Hospital, Prague, Czech Republic
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Bifari IN, Alherabi A, Alkaff H, Al-Arqen H, Jastania RA. Follicular thyroid carcinoma within a thyroglossal duct cyst in adult. Ann Saudi Med 2018; 38:305-308. [PMID: 30078030 PMCID: PMC6086674 DOI: 10.5144/0256-4947.2018.305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
UNLABELLED Thyroglossal duct cyst carcinoma is a rare malignancy, with an incidence of 0.7% to 1.6%. Most cases of thyroglossal duct cyst carcinoma are papillary carcinoma, with follicular carcinoma having been rarely reported. In this study, a 33-year-old man presented with a typical thyroglossal duct cyst and underwent surgical resection of the cyst, which was determined to be follicular carcinoma. We have reported this rare case to increase the awareness of such entities within the general otolaryngology and the community of head and neck surgeons, as well as among endocrine surgeons. SIMILAR CASES PUBLISHED 10.
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Affiliation(s)
- Ibtihaj Nasseraldeen Bifari
- Dr. Ibtihaj Nasseraldeen Bifari, College of Medicine,, Umm Al Qura University,, Makkah 51280,, Saudi Arabia, +966548255614, , ORCID: http://orcid.org/0000-0002-7617-8775
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Locally Advanced Thyroglossal Duct Cyst Carcinoma Presenting as a Neck Mass. Case Rep Endocrinol 2017; 2017:7014313. [PMID: 28573054 PMCID: PMC5440789 DOI: 10.1155/2017/7014313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 03/27/2017] [Indexed: 11/17/2022] Open
Abstract
Thyroglossal duct cyst carcinoma is rare and occurs in just 1% of cases with thyroglossal duct cysts. It is not always possible to distinguish a thyroglossal cyst harboring malignancy from its benign counterparts unless biopsied, thus posing the dilemma. Currently there is no clear consensus on the optimal management of thyroglossal duct cyst carcinoma. Here we present the case of a 69-year-old female who presented with a midline neck mass and dysphagia and was found to have papillary thyroid cancer in the biopsy specimen of the neck mass. She underwent excision of the mass and the thyroglossal duct cyst along with total thyroidectomy; however, the thyroidectomy specimen showed no malignancy. Her lymph node mapping was negative and she is awaiting radioactive iodine treatment.
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Rayess HM, Monk I, Svider PF, Gupta A, Raza SN, Lin HS. Thyroglossal Duct Cyst Carcinoma: A Systematic Review of Clinical Features and Outcomes. Otolaryngol Head Neck Surg 2017; 156:794-802. [DOI: 10.1177/0194599817696504] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective Although thyroglossal duct cysts (TGDCs) are relatively common, malignancies within these lesions are infrequent. As a result, there are no large-scale series describing clinical characteristics. Our objectives were to perform a systematic review of the literature evaluating patient demographics, pathology, management, and prognosis of these patients. Data Sources PubMed, Embase, Cochrane reviews, and Google Scholar were searched for relevant articles. Articles meeting inclusion criteria were reviewed for data detailing epidemiology, treatment, and outcomes. Review Methods Inclusion criteria included English-language articles with original reports on human subjects. Two investigators independently reviewed all articles for the data collected, including epidemiology, treatment, and outcomes. Results Ninety-eight articles comprising 164 patients were included in the final analysis. The mean age at presentation was 39.5 years (9-83 years); 68.3% of patients were female. In total, 73.3% of cases were found on final pathologic analysis. The most common pathology was papillary cancer (92.1%). Of the patients, 98.9% underwent a Sistrunk procedure and 61.0% underwent total thyroidectomy. There was a 4.3% recurrence rate with a mean time to recurrence of 42.1 months from initial treatment. One patient died of TGDC carcinoma, while all other patients were disease free at the time of last follow-up (mean follow-up was 46.1 months). Conclusion TGDC carcinoma is typically diagnosed on final pathology. While management encompasses a Sistrunk procedure, further consideration should be given to thyroidectomy among patients ≥45 years of age and individuals with aggressive disease. TGDC carcinoma harbors an exceedingly low rate of mortality.
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Affiliation(s)
- Hani M. Rayess
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Ian Monk
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Peter F. Svider
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Amar Gupta
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - S. Naweed Raza
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
- Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Ho-Sheng Lin
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
- Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
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Thompson LDR, Herrera HB, Lau SK. Thyroglossal Duct Cyst Carcinomas in Pediatric Patients: Report of Two Cases with a Comprehensive Literature Review. Head Neck Pathol 2017; 11:442-449. [PMID: 28293858 PMCID: PMC5677077 DOI: 10.1007/s12105-017-0807-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 03/01/2017] [Indexed: 10/20/2022]
Abstract
Thyroglossal duct cyst (TGDC) carcinomas are rarely encountered in the pediatric population. The clinical behavior of these tumors in the pediatric setting is unclear and management is not well defined. Two cases of pediatric thyroglossal duct cyst carcinoma were identified in a review of all thyroglossal duct cysts diagnosed over a ten year period. These two cases were analyzed along with 57 cases of thyroglossal duct cyst carcinoma affecting patients less than 21 years of age compiled from the English literature. Fifty-nine patients (36 females, 23 males) aged 6-20 years (mean 15.0 years) were identified. All presented with an anterior midline neck mass, which was typically mobile and non-tender. The average tumor size was 2.6 cm. Histologically, all tumors were papillary thyroid carcinomas arising in a background of a thyroglossal duct cyst. The tumors exhibited a papillary, follicular, or mixed architecture with classical papillary thyroid carcinoma nuclear features. Soft tissue extension was present in 16 cases. All patients were managed surgically with a Sistrunk procedure, with additional thyroidectomy performed in 29 patients, combined with a lymph node dissection (n = 15), or a Sistrunk and lymph node dissection (n = 5). All patients were stage I at presentation, with 11 showing lymph node metastases. Postoperative radioactive iodine was employed in 20 patients. A papillary carcinoma of the thyroid gland was reported in four of the patients who had concurrent/subsequent thyroidectomies. Recurrences were reported in four patients, with distant metastases in one patient, who died of disease (13 months). Follow up data was available for 45 patients, with an overall mean follow-up of 54.5 months. All patients were alive, with the exception of one who died with disease. TGDC carcinomas in pediatric patients is associated with a good overall prognosis, best managed by Sistrunk procedure alone, with selected lymph node dissection if clinically indicated.
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Affiliation(s)
- Lester D. R. Thompson
- 0000 0004 0445 0789grid.417224.6Southern California Permanente Medical Group, Department of Pathology, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91365 USA
| | - Hannah B. Herrera
- 0000 0004 0445 0789grid.417224.6Southern California Permanente Medical Group, Department of Pathology, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91365 USA
| | - Sean K. Lau
- Department of Pathology, Orange County-Anaheim Medical Center, Anaheim, CA USA
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