Does Papillary Carcinoma of Thyroglossal Duct Cyst Develop De Novo?

Thyroglossal Duct Cyst Carcinoma: Lessons from a 20-Case Series

Aims and Objectives

Thyroglossal duct cyst (TDC) is a common congenital cyst with an incidence of about 7%. Thyroglossal duct cyst carcinoma (TDCC) is a rare sequel which arises from TDC and has an incidence of about 1%. As these are rare, they do not have well-defined management guidelines. The aim of this study was to analyse the clinical profile and pathological characteristics of patients with thyroglossal duct cyst carcinoma and to propose a protocol for their treatment and follow-up.

Materials and Methods

A retrospective study was done from January 2000 to December 2019. All the clinical details, imaging characteristics, treatment and histopathology were analysed.

Results

The mean age group in our study was 37.9 years with a female preponderance. The clinical features like rapid increase in size, fixity of the lump and lymph node metastasis were not very common. Seventy-five percent of our patients who underwent imaging had suspicious characteristics. Fifty-six percent of our patients had FNAC suggestive of TDCC. Fifty percent of our patients had concomitant thyroid carcinoma. None of our patients had distant metastasis at follow-up.

Conclusions

TDCC is rare and a disease of young adulthood and usually has good prognosis. It may be a clinical surprise or a small lesion which can be detected with ultrasound and targeted FNAC. There is high rate of concomitant thyroid carcinoma and hence needs careful assessment. Sistrunk's procedure with total thyroidectomy either staged or simultaneously has good outcome and permits adjuvant treatment.

Papillary Thyroid Carcinoma Arising from Thyroglossal Cyst-an Institutional Experience over a Decade

Papillary carcinoma constitutes 80% of thyroglossal duct cyst carcinoma (TGCC). The mainstay of treatment for TGCC is Sistrunk procedure. Due to lack of clear-cut guidelines in managing TGCC, the role of total thyroidectomy, neck dissection and adjuvant radioiodine therapy is still debatable. This was a retrospective study which included cases of TGCC treated in our institution over a period of 11 years. The aim of study was to assess the need for total thyroidectomy in management of TGCC. Patients were divided into two groups based on the surgical treatment they underwent and the treatment outcomes were compared. The histology was papillary carcinoma in all cases of TGCC. Overall, 43.3% of TGCCs had a focus of papillary carcinoma in total thyroidectomy specimen. Lymph node metastasis was noted only in 10% of TGCC and not identified in isolated papillary carcinoma confined to thyroglossal cyst. 7-year overall survival (OS) for TGCC was 83.1%. Prognostic factors like extracapsular extension or lymph node metastasis did not affect OS. Addition of total thyroidectomy and neck dissection to Sistrunk procedure did not offer any survival advantage. In a case of TGCC, FNAC should be done from any clinically suspicious thyroid nodules or lymph nodes. TGCC has a good prognosis following treatment and none of the cases in our series has disease recurrence during follow-up. Sistrunk procedure was an adequate procedure for treatment of TGCC with clinically and radiologically normal thyroid gland.

Papillary Carcinoma in Thyroglossal Duct Cyst and Thyroid Gland with Hashimoto

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.

Management of the Thyroid Gland in Papillary Carcinoma of the Thyroglossal Cyst: A Case Report

Carcinoma arising in a thyroglossal cyst is rare. We present a case of anterior neck swelling diagnosed to be thyroglossal cyst clinically which turns out to be a papillary carcinoma arising in thyroglossal cyst. She underwent sistrunk procedure with total thyroidectomy and diseasefree on follow up evaluation. Even though preoperative ultrasonography had shown thyroid nodule, the final histology did not show malignancy. There is a paucity of clear-cut guidelines in the management of the thyroid gland in a thyroglossal cyst carcinoma. In thyroglossal cyst carcinoma cases, we recommend thyroidectomy only when there is a thyroid nodule with high-risk features.

Papillary thyroglossal duct carcinoma: report of nine cases and review of literature

BACKGROUND

Thyroglossal duct carcinoma (TDCa) is a rare malignancy. Thus, we summarized the clinical characteristics of TDCa to explore the strategy of diagnosis, surgical treatment, and prognosis of patients with papillary TDCa.

CASE PRESENTATION

A retrospective study was conducted about the medical records of cases with TDCa. General information including the diagnosis, surgical treatment, and prognosis of patients were obtained and analyzed. A total of 480 patients with thyroglossal duct anomalies were treated in our hospital during 1981 to 2011. Nine patients were identified as papillary TDCa and Sistrunk procedure was performed in these patients. Total thyroidectomy and selected neck dissection were performed in 3 TDCa patients with additional multiple thyroid nodules at presentation, of whom one was diagnosed as papillary thyroid carcinoma and another was found to have lymph node metastases. With a median follow-up of 119 months, all patients were alive with no recurrences or metastases.

CONCLUSIONS

Although the incidence of TDCa is very low, early diagnosis and surgical operation of TDCa should be performed as soon as possible. Besides, the pathological examination is the only way to confirm the diagnosis, and surgery, especially Sistrunk's procedure, is the prior choice of the treatments. In the presence of thyroid lesions or cervical lymphadenopathy, total thyroidectomy and neck dissection should be considered.

Simultaneous Papillary Carcinoma in Thyroglossal Duct Cyst and Thyroid

Thyroglossal duct cyst (TDC) is a cystic expansion of a remnant of the thyroglossal duct tract. Carcinomas in the TDC are extremely rare and are usually an incidental finding after the Sistrunk procedure. In this report, an unusual case of a 36-year-old woman with concurrent papillary thyroid carcinoma arising in the TDC and on the thyroid gland is presented, followed by a discussion of the controversies surrounding the possible origins of a papillary carcinoma in the TDC, as well as the current management options.