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Houas J, Ghammam M, Laabidi E, Khalfi O, Bellakhdher M, Abdelkefi M. Malignant degeneration of thyroglossal duct cysts: Clinical aspects, imaging findings and management: Case series. Int J Surg Case Rep 2024; 115:109325. [PMID: 38301307 PMCID: PMC10847149 DOI: 10.1016/j.ijscr.2024.109325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Thyroglossal duct cysts (TDCs) are congenital anomalies that can rarely undergo malignant transformation, with approximately 1 % of operated TDCs demonstrating malignant degeneration. Therapeutic management and follow-up methods are still controversial subjects. CASE SERIES PRESENTATION We report 3 cases of a papillary carcinoma of thyroid occurring in a thyroglossal duct cyst. The diagnosis was suspected preoperatively in 2 patients, hence the indication of frozen section examination. All patients underwent Sistrunk procedure associated with total thyroidectomy and central neck dissection. Concomitant papillary thyroid carcinoma was found in 2 patients. A complementary treatment by radioactive iodine 131 with frenetic hormone therapy was undertaken in all the cases. The follow-up showed no recurrence. CLINICAL DISCUSSION The clinical presentation of thyroglossal duct cyst carcinoma is often nonspecific, posing challenges in early diagnosis. The chosen treatment strategy, involving the Sistrunk procedure, total thyroidectomy, and central neck dissection, along with adjuvant therapy using radioactive iodine 131 and frenetic hormone therapy, was effective in preventing recurrence. CONCLUSION The management of degenerated TDC is based on a multidisciplinary approach. Papillary carcinomas of TDC generally have a good prognosis.
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Affiliation(s)
- Jihene Houas
- University of Sousse Faculty of Medicine of Sousse, ENT Department, Farhat Hached University Hospital, Sousse, Tunisia.
| | - Monia Ghammam
- University of Sousse Faculty of Medicine of Sousse, ENT Department, Farhat Hached University Hospital, Sousse, Tunisia
| | - Eya Laabidi
- University of Sousse Faculty of Medicine of Sousse, ENT Department, Farhat Hached University Hospital, Sousse, Tunisia
| | | | - Mouna Bellakhdher
- University of Sousse Faculty of Medicine of Sousse, ENT Department, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Abdelkefi
- University of Sousse Faculty of Medicine of Sousse, ENT Department, Farhat Hached University Hospital, Sousse, Tunisia
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Themeli Y, Sinaj E, Hysa E, Nakuci D, Alimehmeti M, Sakellariou G. Papillary Carcinoma in Thyroglossal Duct Cyst and Thyroid Gland with Hashimoto. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.11000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The ectopic thyroid gland is a rare condition. In most cases, ectopic thyroid tissue is the only functioning thyroid tissue, but it may rarely be associated with a normal thyroid gland. Ectopic thyroid carcinoma within a thyroglossal duct cyst is a very rare entity, with controversial individual approaches. This encouraged us to present the case of a 31-year- old woman, with papillary thyroid carcinoma in the thyroid gland and in the thyroid ectopic tissue within the thyroglossal duct. After suspicion of thyroid malignancy in the ultrasonography of the neck, FNA-biopsy was performed on the thyroid nodule and the thyroglossal duct cyst. Since the pathological exam revealed a papillary carcinoma in the eutopic and ectopic thyroid tissues, the Sistrunk procedure and total thyroidectomy were done, followed by radioiodine ablation.
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Coexisting Thyroglossal Duct Cyst with Papillary Thyroid Cancer: A Case Report and Literature Review. Case Rep Otolaryngol 2022; 2021:6111308. [PMID: 34987876 PMCID: PMC8720604 DOI: 10.1155/2021/6111308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/16/2021] [Indexed: 11/18/2022] Open
Abstract
Thyroglossal duct cysts (TGDCs) are common developmental anomalies in which the thyroglossal duct is not obliterated. Coexisting papillary thyroid cancer and TGDC are uncommon and should be investigated thoroughly to rule out TGDC carcinoma. We report a rare case of coexisting papillary thyroid cancer and TGDC in a 48-year-old man, who presented with a history of recurrent mild painful midline neck swelling, and ultrasound (US) revealed a TGDC that was subsequently managed conservatively. On follow-up after 1.6 years, a thyroid US and a fine-needle aspiration (FNA) biopsy were performed, which showed malignant papillary thyroid carcinoma. Total thyroidectomy, the Sistrunk procedure, and central neck dissection were implemented. After three days, the patient was discharged on 150 mg of levothyroxine. Follow-up was unremarkable with no complications. The authors would like to stress the importance of regular TGDC and thyroid gland follow-ups for early detection and diagnosis of thyroid malignancy via clinical examination and US.
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Korbi AE, Houas J, Bouatay R, Harrathi K, Koubaa J. Primary papillary carcinoma of the thyroglossal duct in a 14-year-old female: case report and review of the literature. Pan Afr Med J 2019; 32:121. [PMID: 31223411 PMCID: PMC6560953 DOI: 10.11604/pamj.2019.32.121.15246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 02/02/2019] [Indexed: 11/11/2022] Open
Abstract
Thyroglossal duct carcinoma is a rare pathologic entity. The surgeon's main concern is whether to perform thyroidectomy or not. In this paper, we report another case of thyroglossal papillary duct carcinoma in a 14-old girl suspected preoperatively and confirmed postoperatively on the histological analysis of resected specimen by a Sistrunk procedure. Therapeutic strategy was completed by a total thyroidectomy with radioactive iodine therapy and suppressive levothyroxine therapy. In the absence of clear guidelines, the management of thyroglossal duct carcinoma is depending on the clinical situation and the experience of the team of surgeons.
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Affiliation(s)
- Amel El Korbi
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Monastir, Tunisia.,Healthcare Research Unit UR12SP41, Tunisia
| | - Jihène Houas
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Monastir, Tunisia
| | - Rachida Bouatay
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Monastir, Tunisia
| | - Khaled Harrathi
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Monastir, Tunisia
| | - Jamel Koubaa
- ENT Department, Fattouma Bourguiba Hospital of Monastir, University of Monastir, Monastir, Tunisia
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Nightingale M. Midline cervical swellings: What a paediatrician needs to know. J Paediatr Child Health 2017; 53:1086-1090. [PMID: 29148189 DOI: 10.1111/jpc.13759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 08/25/2017] [Accepted: 08/29/2017] [Indexed: 11/30/2022]
Abstract
Midline cervical swellings are a heterogeneous group of conditions in children. Careful clinical examination will allow a diagnosis to be made in many instances and appropriate investigations to be performed before referral to surgical services. The approach to clinical examination, investigation and management of the most common conditions is described.
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Affiliation(s)
- Michael Nightingale
- Paediatric Surgery, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
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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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Al-Hadidi A, Mohammed A, Morden R. Thyroglossal duct papillary carcinoma with squamous metaplasia in a 12-year old female and review of literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Yim MT, Tran HD, Chandy BM. Incidental radiographic findings of thyroglossal duct cysts: Prevalence and management. Int J Pediatr Otorhinolaryngol 2016; 89:13-6. [PMID: 27619021 DOI: 10.1016/j.ijporl.2016.07.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 07/17/2016] [Accepted: 07/21/2016] [Indexed: 01/14/2023]
Abstract
OBJECTIVES/HYPOTHESIS To determine the epidemiology of incidental thyroglossal duct cysts (TGDC) discovered on imaging studies obtained in the head and neck area in children and to discuss subsequent management. METHODS A retrospective chart review was performed at Texas Children's Hospital of all computed tomography (CT) and magnetic resonance (MR) imaging studies obtained in the head and neck region between July 2011 and July 2014. Images obtained for the purpose of evaluating a neck or lingual mass were excluded from the study, as were patients with previously known TGDCs. Data including age, sex, location of TGDC, size, presence of symptoms, referral to Otolaryngology, and intervention were recorded. RESULTS A total of 60,663 CT and MR studies of the head, brain, sinus, neck, and C-spine during this time period were reviewed; of these 69 (0.1%) cases contained incidental discovery of probable TGDCs with more males (40) than females (29). Ages ranged from 3 days to 17 years old, with the mean age at 5 years. Locations varied, with majority at base of tongue (83%) followed by hyoid (13%) then infrahyoid straps (4%). Sizes ranged from 2 to 28 mm with average size at 8 mm. 11 of these patients were referred to an Otolaryngologist; 9 were asymptomatic and decision was made to observe, the other two subsequently underwent surgical excision secondary to mass effect and dysphagia with histologic confirmation of diagnosis. CONCLUSION TGDCs commonly present as an anterior neck mass, however the majority of incidentally discovered TGDCs on imaging are located at the base of tongue. Management of these findings should include referral to an Otolaryngologist for further evaluation with the decision to intervene surgically based on development of clinical symptoms.
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Affiliation(s)
- Michael T Yim
- Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, One Baylor Plaza, Mail Stop: NA-102, Houston, TX 77030, USA.
| | - Huy D Tran
- Department of Pediatric Radiology, Neuroradiology Section, Texas Children's Hospital, 6701 Fannin Street, Suite 470, MC 2-270, Houston, TX 77030, USA.
| | - Binoy M Chandy
- Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, One Baylor Plaza, Mail Stop: NA-102, Houston, TX 77030, USA; Division of Otolaryngology, Texas Children's Hospital, Houston, TX, USA.
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Abstract
Proper management of pediatric thyroid nodules is crucial to achieving good outcomes. It is important to obtain a thorough history, including prior radiation exposure and family history of thyroid cancer and any symptoms of hypothyroidism or hyperthyroidism. A complete physical examination with special attention to the thyroid gland and any cervical lymphadenopathy is important. Nodules between 5 and 10 mm with risk factors (clinical or sonographic) and all nodules greater than 10 mm should undergo a fine-needle aspiration biopsy. A comprehensive center of pediatric specialists is the best environment for treatment of these patients.
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Affiliation(s)
- Kris R Jatana
- Department of Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital, The Ohio State University, 555 South 18th Street, Suite 2A, Columbus, OH 43205, USA
| | - Donald Zimmerman
- Department of Pediatrics, Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Chicago, IL 60611, USA.
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Seow-En I, Loh AHP, Lian DWQ, Nah SA. Thyroglossal duct cyst carcinoma: diagnostic and management considerations in a 15-year-old with a large submental mass. BMJ Case Rep 2015; 2015:bcr-2015-210923. [PMID: 26150648 DOI: 10.1136/bcr-2015-210923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
A 15-year old boy presented with a 2-year history of a painless slowly enlarging submental neck mass. Head and neck imaging showed a multicystic mass with a central solid component that was closely applied to the hyoid bone. Core needle biopsy under general anaesthesia revealed a papillary thyroid neoplasm. The mass was resected and frozen section histology confirmed papillary carcinoma. Intraoperatively, enlarged cervical lymph nodes were palpable. Bilateral neck dissections and total thyroidectomy with parathyroid reimplantation were performed. On histological examination, the thyroid gland was not involved. The patient recovered uneventfully from the surgery and is planned for radioactive iodine therapy and thyroxine suppression, with subsequent follow-up with serum thyroid-stimulating hormone and thyroglobulin for surveillance. We review the literature and discuss challenges in the diagnosis and surgical management of this rare entity in the paediatric age group.
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Affiliation(s)
- Isaac Seow-En
- Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore, Singapore
| | - Amos Hong Pheng Loh
- Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore, Singapore
| | - Derrick Wen Quan Lian
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Shireen Anne Nah
- Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore, Singapore
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Abstract
Papillary thyroid carcinoma occurring in a thyroglossal cyst is a rare condition especially in children, and there is no consensus regarding management. There are only 10 other documented cases in the English literature for children under the age of 12. We discuss one such case. A 10-year-old female child with an 8-month history of a midline neck cyst underwent Sistrunk's procedure as surgical treatment after clinical and ultrasound scan confirmation. An incidental 9-mm papillary carcinoma was seen on histology within the thyroglossal cyst. Following multidisciplinary team (MDT) discussion, the child underwent total thyroidectomy and radioiodine ablation. There is no consensus regarding the ideal management for thyroglossal duct carcinoma in the paediatric literature. We discuss the treatment options and the importance of MDT involvement.
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Affiliation(s)
- Asil Tahir
- Department of Otolaryngology/Head and Neck Surgery, Leeds General Infirmary, Leeds, UK
| | - Velayutham Sankar
- Department of Otolaryngology/Head and Neck Surgery, Leeds General Infirmary, Leeds, UK
| | - Zvoru Makura
- Department of Otolaryngology/Head and Neck Surgery, Leeds General Infirmary, Leeds, UK
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