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Murgod PS, Jaison J, Dhande S, Bhide S. Papillary Thyroid Carcinoma within a Thyroglossal Cyst: A Rare Case Report with Review of Literature. Indian J Otolaryngol Head Neck Surg 2024; 76:1101-1105. [PMID: 38440585 PMCID: PMC10908700 DOI: 10.1007/s12070-023-04141-1] [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: 06/30/2023] [Accepted: 08/16/2023] [Indexed: 03/06/2024] Open
Abstract
Thyroglossal cyst (TGC) is the most common congenital anomaly of the thyroid gland and is found in approximately 7% of general population. It represents cystic degeneration of a remnant of the thyroglossal duct that failed to involute during gestation. Malignancy occurring in TGC is rare entity, accounting only for 1% of all thyroglossal cysts. We are presenting such a rare case of papillary thyroid carcinoma arising in a thyroglossal cyst. 30-year-old female presented with a painless, gradually progressive swelling below the chin extending to left side. On examination, swelling was noted in submental region and measuring 4 × 3 × 1 cm, firm in consistency and moves with deglutition and movement of tongue. On radiological investigations, lobulated cystic lesion in midline with thin septations was seen, suggestive of thyroglossal cyst. The thyroid of the patient was normal. Patient underwent Sistrunk procedure. On histopathology, papillary thyroid carcinoma in thyroglossal cyst was seen and it was invading cyst wall and superficial skeletal muscle. The 1st case of thyroglossal duct carcinoma was reported by Brentano in 1911. Till now 300 cases have been reported in literature. Carcinomas occurring in thyroglossal cyst are extremely rare, (< 1% cases). The most frequent histological type is papillary pattern followed by mixed(papillary and follicular), squamous cell, Hürthle cell, follicular and anaplastic variety. The etiology of thyroglossal duct carcinoma is unknown and neither good clinical history nor examination can lead to a preoperative diagnosis. Diagnosis is often incidental on histopathology as in present case. Thyroglossal duct carcinoma is a rare condition that comes as a surprise to both the patient and surgeon and should be considered in patients presenting with cystic midline neck masses.
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Affiliation(s)
- Priyanka Sangappa Murgod
- Department of Pathology, KAHER’s Jagadguru Gangadhar Mahaswamigalu Moorusavirmath Medical College, Huballi, Karnataka India
| | - Janice Jaison
- Department of Pathology, MAEER MIT Pune’s MIMER Medical College and Dr. BSTR Hospital, Talegaon Dabhade, Pune, Maharashtra India
| | - Sayli Dhande
- Department of Pathology, MAEER MIT Pune’s MIMER Medical College and Dr. BSTR Hospital, Talegaon Dabhade, Pune, Maharashtra India
| | - Smita Bhide
- Department of Pathology, MAEER MIT Pune’s MIMER Medical College and Dr. BSTR Hospital, Talegaon Dabhade, Pune, Maharashtra India
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Mylopotamitaki K, Klonaris D, Kazamias G, Simandirakis C, Vourliotaki I, Karakostas E. A Rare Case Report of Thyroglossal Duct Cyst Carcinoma Coexisting with Thyroid Carcinoma in an Adolescent. Case Rep Otolaryngol 2023; 2023:6640087. [PMID: 37705684 PMCID: PMC10497364 DOI: 10.1155/2023/6640087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/31/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023] Open
Abstract
Background Thyroglossal duct cysts (TDC) represent approximately 70% of all congenital neck masses, and up to 1% of them contain thyroid tissue malignancies. Clinical presentation of TDC carcinomas is usually indistinguishable from benign tumors preoperatively, and differential diagnosis can be challenging. We present a rare case of TDC carcinoma concurrent with thyroid cancer in an adolescent. Case Presentation. A 16-year-old Caucasian female, otherwise healthy, was referred with a painless, gradually expanding lump on the neck. Physical examination revealed a well-circumscribed, moderately hard, tender mass of the anterior neck midline anteroinferior to the hyoid bone. Imaging findings suggested TDC as the most likely diagnosis. The patient had a Sistrunk procedure under general anesthesia. Histopathological findings diagnosed a BRAFV600E-positive papillary thyroid carcinoma (PTC) in a TDC. A thyroid gland and neck ultrasound revealed a highly suspicious finding for malignancy right level VI lymph node, which was not confirmed by fine needle aspiration cytology (FNAC). Under general anesthesia, total thyroidectomy and central compartment lymph node neck dissection were performed. Histopathological findings revealed a thyroid parenchymal locus of PTC, as well as three lymph nodes infiltrated by PTC. The patient received adjuvant radioactive iodine ablation (RAI) therapy and is closely followed. Conclusion TDC carcinomas in conjunction with thyroid carcinomas in young patients are rare. Preoperative diagnosis can be challenging, as the vast majority of neck masses in young patients are benign in nature, and most malignant tumors lack specific clinical features. The diagnostic accuracy of FNAC is considered unsatisfactory due to its frequently cystic nature. Definitive diagnosis is based on histopathological findings. Clinicians should maintain a high level of suspicion for coexisting thyroid malignancies. Although surgical extirpation of the malignancy is considered standard of care, the treatment of TDC cancer should always be individualized by a multidisciplinary team.
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Affiliation(s)
- Kleanthi Mylopotamitaki
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
- University of Crete, School of Medicine, Greece
| | - Dionisios Klonaris
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
| | - Georgios Kazamias
- Department of Pathology, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
| | - Christos Simandirakis
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
| | - Irene Vourliotaki
- Department of Endocrinology, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
| | - Efthimios Karakostas
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion “Venizeleio-Pananeio”, Heraklion, Crete, Greece
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Sen S, Thomas SS, Cherian A, Abraham D, Hepzhibah J, John R, Therese M, Reka K, Paul MJ. Thyroglossal Duct Cyst Carcinoma: Lessons from a 20-Case Series. Indian J Surg Oncol 2023; 14:609-618. [PMID: 37900628 PMCID: PMC10611691 DOI: 10.1007/s13193-023-01720-0] [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: 07/29/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
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.
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Affiliation(s)
- Supriya Sen
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Shawn Sam Thomas
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Anish Cherian
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Deepak Abraham
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Julie Hepzhibah
- Department of Nuclear Medicine, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Reetu John
- Department of Radiology, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - Marie Therese
- Department of Pathology, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - K. Reka
- Department of Biostatistics, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
| | - M. J. Paul
- Department of Endocrine Surgery, CMC Hospital Vellore, Vellore, 632004 Tamil Nadu India
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Solis-Pazmino P, Figueroa L, Pilatuña EA, Rocha C, Godoy R, García C. Surgical approach for thyroglossal duct cyst cancer: a case report of challenging conventional thinking. J Surg Case Rep 2023; 2023:rjad448. [PMID: 37560599 PMCID: PMC10409589 DOI: 10.1093/jscr/rjad448] [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: 07/09/2023] [Accepted: 07/20/2023] [Indexed: 08/11/2023] Open
Abstract
This article reports an older woman with a 2-year history of enlarging submental neck mass. Head and neck imaging displayed a group with a solid central component. Additionally, a fine-needle aspiration suggested neoplasia. Thyroglossal duct cyst cancer is sporadic, accounting for ˂1% of all thyroid malignancies. A Sistrunk procedure was followed by a total thyroidectomy and unilateral neck dissections. From histological and immunohistochemical examinations, the incidental finding of carcinoma indicates the diagnosis of thyroid tissue thyroglossal duct cyst carcinoma, as it is the most common site for malignancy in ectopic thyroid tissue. The patient had an excellent recovery without additional treatments after surgery.
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Affiliation(s)
- Paola Solis-Pazmino
- Head and Neck Surgery Department, Instituto de Tiroides y Enfermedades de Cabeza y Cuello (ITECC), Quito, Ecuador
- The Surgery Group of Los Angeles, 8635 W 3rd St #880, Los Angeles, CA 90048, USA
| | - Luis Figueroa
- Head and Neck Surgery Department, Instituto de Tiroides y Enfermedades de Cabeza y Cuello (ITECC), Quito, Ecuador
- Universidad Central del Ecuador, Quito, Pichincha, Ecuador
| | - Eduardo Andres Pilatuña
- Head and Neck Surgery Department, Instituto de Tiroides y Enfermedades de Cabeza y Cuello (ITECC), Quito, Ecuador
- Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
| | - Carla Rocha
- IpathLab: Instituto de Patología y Medicina de Laboratorio, Quito, Ecuador
| | - Richard Godoy
- Head and Neck Surgery Department, Instituto de Tiroides y Enfermedades de Cabeza y Cuello (ITECC), Quito, Ecuador
| | - Cristhian García
- Head and Neck Surgery Department, Instituto de Tiroides y Enfermedades de Cabeza y Cuello (ITECC), Quito, Ecuador
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Thyroglossal duct cyst papillary thyroid cancer – the state of the art. CURRENT ISSUES IN PHARMACY AND MEDICAL SCIENCES 2021. [DOI: 10.2478/cipms-2021-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Thyroglossal duct cyst is one of the most common congenital malformations in the neck area. The majority of cysts turn out to be benign tumors, however, 0.7-1.5 % of the remnants develop into carcinoma, with papillary thyroid cancer being the most frequent malignant neoplasm. The origin of the cancer has not been clearly established so far. Typically, thyroglossal duct cyst cancer is an enlarging flexible midline or slightly lateral neck mass, most often without other worrisome symptoms. The proper diagnosis can be difficult due to the rare prevalence of thyroglossal duct cyst papillary thyroid carcinoma, as well as a lack of strongly typical features distinguishing benign and malignant lesions before surgery. Thus, diagnosis is usually made postoperatively just after histopathological examination of a resected cyst. However, there are diagnostic procedures that should be considered before the surgery that may be helpful in making a proper diagnosis. These include fine-needle aspiration biopsy, computed tomography or magnetic resonance imaging. Moreover, there are some characteristics revealed through clinical and ultrasound examination that may suggest the presence of such cancer. While the Sistrunk procedure is often considered adequate, currently, there is no clear consensus about concurrent thyroidectomy or radioiodine therapy. In the article, we sum up the preoperative suggestive factors of cancer, as well as the proposed indications that can be helpful in deciding on the extent of surgery and further management.
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Case report: Thyroglossal duct cyst papillary carcinoma in a young male. ANNALES D'ENDOCRINOLOGIE 2021; 82:126-128. [PMID: 33636183 DOI: 10.1016/j.ando.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 11/22/2022]
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