1
|
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.
Collapse
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
| |
Collapse
|
2
|
Shukla S, Dwivedi G, Goyal S, Sengupta P. 'Lateral Aberrant Thyroid Carcinoma' or 'Thyroglossal Duct Cyst Carcinoma Metastasizing to Neck Node': Can we Decide in this Interesting Case Report?. Indian J Otolaryngol Head Neck Surg 2023; 75:2626-2629. [PMID: 37636601 PMCID: PMC10447327 DOI: 10.1007/s12070-023-03874-3] [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: 04/27/2023] [Accepted: 05/06/2023] [Indexed: 08/29/2023] Open
Abstract
Lateral aberrant thyroid(LAT) belongs to subset of ectopic thyroid, mostly presenting as asymptomatic lateral neck swelling and are challenging to diagnose without histopathological examination. Malignant transformation in LAT is even rare and is best managed by surgical excision. Here, we report a case of papillary carcinoma of LAT, but with an unusual post-operative finding, revealing papillary carcinoma of thyroglossal duct cyst.
Collapse
Affiliation(s)
- Shambhavi Shukla
- Department of ENT, Command Hospital (Eastern Command), Alipore-700027, Kolkata, India
| | - Gunjan Dwivedi
- Department of ENT, Command Hospital (Eastern Command), Alipore-700027, Kolkata, India
| | - Sunil Goyal
- Department of ENT, Command Hospital (Eastern Command), Alipore-700027, Kolkata, India
| | - P Sengupta
- Department of Pathology, Command Hospital (Eastern Command), Alipore-700027, Kolkata, India
| |
Collapse
|
3
|
Muhialdeen AS, Salih AM, Ahmed MM, Saeed YA, Qaradakhy AJ, Baba HO, Abdullah AM, Kakamad FH, Mohammed SH, Hiwa DS, Mohammed MS, Najmadden ZB. Thyroglossal duct diseases: presentation and outcomes. J Int Med Res 2023; 51:3000605231154392. [PMID: 36799092 PMCID: PMC9940199 DOI: 10.1177/03000605231154392] [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] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE The incidence of thyroglossal duct diseases in the general population is about 7%. We aimed to demonstrate the clinical presentations and management of thyroglossal duct diseases. METHODS We conducted a retrospective review of all patients who underwent surgery for histopathologically confirmed thyroglossal duct cyst, sinus, or fistula at a single center. RESULTS A total of 151 cases were included in this study. There were more female patients (87, 58%) than male patients (64, 42%). The patients' ages ranged from 1 to 63 years old. The most prevalent complaint was painless upper midline neck swelling (93.3%). Most cases were diagnosed as thyroglossal duct cysts (137, 90.7%). Six cases (4%) were associated with carcinoma. All the cases were managed using the modified Sistrunk procedure. There were no procedure-related complications, and five cases of recurrence. CONCLUSIONS Although thyroglossal duct cyst is the most common neck anomaly in children, it may also present with various characteristics later in life. This condition can be managed successfully without complications and with a low recurrence rate.
Collapse
Affiliation(s)
- Aso S. Muhialdeen
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Abdulwahid M. Salih
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Mohsin M. Ahmed
- Department of Surgery, Teaching Hospital, Ministry of Health, Sulaimani, Kurdistan, Iraq
| | - Yadgar A. Saeed
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Aras J. Qaradakhy
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,Department of Radiology, Shorsh Teaching Hospital, Sulaimani, Kurdistan, Iraq
| | - Hiwa O. Baba
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Ari M. Abdullah
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | - Fahmi H. Kakamad
- Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq,College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq,Fahmi Hussein Kakamad, Doctor City, Building 11, Apartment 50, Sulaimani, Kurdistan 46001, Iraq.
| | - Shvan H. Mohammed
- Kscien Organization, Hamdi Str, Azadi Mall, Sulaimani, Kurdistan, Iraq
| | - Dilan Sarmad Hiwa
- College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
| | | | | |
Collapse
|
4
|
Dhingra S, Juneja R, Tigga A. Papillary Carcinoma of Thyroglossal Cyst with Thyroid Hemiagenesis: Is Conservative Surgical Management Enough? Indian J Otolaryngol Head Neck Surg 2022; 74:1992-1995. [PMID: 36452739 PMCID: PMC9701970 DOI: 10.1007/s12070-020-01951-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/04/2020] [Indexed: 11/25/2022] Open
Abstract
We describe a case of papillary carcinoma in a thyroglossal cyst with left hemiagenesis of the thyroid gland in a 24-year-old female patient. We opted not to perform a total thyroidectomy as the patient was at low risk for aggressive disease. In this article we review the criteria for selection of thyroidectomy in incidentally discovered papillary carcinomas after thyroglossal cyst excision and management protocol in case of coexisting thyroid hemi-agenesis. To our knowledge, this case represents the second case report of an association between left thyroid hemiagenesis and thyroglossal duct cyst papillary carcinoma.
Collapse
Affiliation(s)
- Shruti Dhingra
- Department of Otolaryngology, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi, India
| | - Ruchika Juneja
- Department of Otolaryngology, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi, India
| | - Anjana Tigga
- ESIC Medical College and Hospital, JOKA, Kolkatta, India
| |
Collapse
|
5
|
Peres C, Rombo N, Guia Lopes L, Simões C, Roque R. Thyroglossal Duct Cyst Carcinoma With Synchronous Thyroid Papillary Carcinoma: A Case Report and Literature Review. Cureus 2022; 14:e28570. [PMID: 36059313 PMCID: PMC9428416 DOI: 10.7759/cureus.28570] [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] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Thyroglossal duct cysts (TGDC) are one of the most common congenital anomalies in the neck. Malignant transformation of these cysts is rare and synchronous involvement of the thyroid gland is even rarer. We report a case of synchronous occurrence of carcinoma in the thyroglossal duct cyst and thyroid gland and review the relevant literature. A 24-year-old woman who presented with a midline cervical mass, clinical examination, and complementary study was suggestive of a thyroglossal cyst with papillary carcinoma on fine-needle aspiration biopsy (FNAB) synchronous with thyroid papillary carcinoma with no cervical ganglion metastases documentation. Sistrunk’s procedure plus total thyroidectomy was performed. With the clinical resemblance of benign and malignant cysts and the limitations of imaging techniques to distinguish between them, FNAB might be of use. Surgical treatment is warranted for the treatment of thyroglossal duct cyst carcinoma, but controversy still exists as to the extent of the surgical intervention. Sistrunk’s procedure seems to be considered the gold standard when there is no evidence of thyroid involvement. However, in the presence of concomitant thyroid carcinoma, total thyroidectomy and cervical lymphadenectomy for evident node metastases are required. In the case of synchronous thyroglossal and thyroid carcinoma, most authors recommend pursuing both radioiodine therapy and hormone ablation. Thyroglossal duct cyst carcinoma is an uncommon feature that can arise from clusters of thyroid cells found within the cyst as in the present case. When confronted with this diagnosis it is fundamental to take into consideration the possibility of synchronous lesions as well as the extent of local and distance disease, since it has a direct influence on the choice of treatment provided to the patient. As there was a synchronous presence of papillary carcinoma in both the thyroglossal cyst and the thyroid gland, both the Sistrunk procedure and total thyroidectomy were performed, and radioiodine therapy was pursued as well as hormone ablation.
Collapse
|
6
|
Alqahtani SM, Rayzah M, Al Mutairi A, Alturiqy M, Hendam A, Bin Makhashen M. Papillary carcinoma arising from a thyroglossal duct cyst: A case report and literature review. Int J Surg Case Rep 2022; 94:107106. [PMID: 35468382 PMCID: PMC9052137 DOI: 10.1016/j.ijscr.2022.107106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Papillary carcinoma originating from a thyroglossal cyst is rare and peculiar, with majority of cases detected after surgery. Despite an excellent prognosis, its management remains controversial. Herein, we report the case of a 53-year-old woman who underwent Sistrunk procedure for a thyroglossal duct cyst and was subsequently confirmed to have papillary thyroid carcinoma. Presentation of case A 53-year-old woman presented with an anterior midline neck mass for 7 years. The patient had no symptoms of hypo-or hyperthyroidism. Additionally, she had no history of compressive symptoms. Neck ultrasound revealed a well-defined 3.5 cm × 2.2 cm × 3 cm-sized cystic lesion inferior to the hyoid bone, with a peripheral solid component. Neck computed tomography revealed a well-defined 3.7 cm × 3.4 cm × 2.7 cm-sized cystic lesion with an enhanced central solid component with focal calcifications, inferior to the hyoid bone, and in contact with the anterior wall of the thyroid cartilage. Sistrunk procedure was performed. The patient was then diagnosed with papillary thyroid carcinoma with TNM stage pT2 and underwent total thyroidectomy as a follow-up procedure. Discussion Thyroglossal duct cyst carcinoma is usually detected in the fourth decade of life with a higher prevalence in women. Neck ultrasound is performed during the initial radiological workup to assess the cyst and confirm the presence of the thyroid gland. Conclusion The Sistrunk procedure is highly effective in low-risk patients. A more aggressive approach is required for high-risk patients. Papillary carcinoma originating from a thyroglossal cyst is a rare tumour. TGDCC is usually diagnosed postoperatively and has an excellent prognosis. The Sistrunk procedure is required in all cases of TGDCC as the initial approach. Currently there is no consensus regarding the proper management of TGDCC.
Collapse
Affiliation(s)
- Saad M Alqahtani
- Department of Surgery, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia.
| | - Musaed Rayzah
- Department of Surgery, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia.
| | - Ahmed Al Mutairi
- Department of Internal medicine, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia.
| | - Mohammed Alturiqy
- Radiology and Medical imaging Department, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia.
| | - Ahmed Hendam
- Department of Surgery, King Khalid Hospital, Al-Majmaah 15392, Saudi Arabia.
| | - Maraei Bin Makhashen
- Department of Pathology, Prince Mohammed Bin Abdul Aziz Hospital, Riyadh 11676, Saudi Arabia.
| |
Collapse
|
7
|
Invasive primary papillary carcinoma in a thyroglossal duct cyst: A case report and review of the literature. HUMAN PATHOLOGY: CASE REPORTS 2019. [DOI: 10.1016/j.ehpc.2018.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
8
|
Wood CB, Bigcas JL, Alava I, Bischoff L, Langerman A, Kim Y. Papillary-Type Carcinoma of the Thyroglossal Duct Cyst: The Case for Conservative Management. Ann Otol Rhinol Laryngol 2018; 127:710-716. [DOI: 10.1177/0003489418791892] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objectives: Thyroglossal duct cyst (TGDC) is the most common congenital neck mass, presenting in up to 7% of the population. TGDC carcinoma is much less common, occurring in roughly 1% of patients diagnosed with TGDC. The vast majority of these tumors are papillary-type thyroid cancer. Given its rarity, there is wide variation in management recommendations for this disease. Extent of surgical management and need for adjuvant therapy including radioactive iodine ablation (RAI) are particularly debated, with some authors arguing aggressive therapy including RAI for any patients who undergo concurrent thyroidectomy with the Sistrunk procedure for TGDC carcinoma. We present a series of patients treated for TGDC carcinoma at our institutions and discuss our management algorithm. Methods: This is a retrospective chart review of patients with TGDC treated at 2 separate institutions. Factors reviewed included patient age, sex, preoperative diagnosis, preoperative work-up, extent of therapy, and use of adjuvant therapy. Results: Six patients who were treated for TGDC carcinoma at our institutions were identified. One patient was excluded because the patient had been treated at an outside facility prior to referral. All patients had papillary-type thyroid cancer. One patient underwent the Sistrunk procedure alone, and the remaining 4 underwent the Sistrunk procedure plus total thyroidectomy. Two of 4 patients were noted to have malignancy in the thyroid. Two of 4 patients who underwent thyroidectomy additionally received adjuvant RAI. Conclusion: Thyroglossal duct cyst carcinoma is uncommon and management is controversial. In low-risk patients (single tumor focus, negative margins, normal preoperative neck/thyroid imaging, no extension of TGDC carcinoma beyond the cyst wall), the Sistrunk procedure alone with observation of the thyroid may be sufficient. In this patient population, RAI is unlikely to be of any substantial benefit.
Collapse
Affiliation(s)
- C. Burton Wood
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jo-Lawrence Bigcas
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ibrahim Alava
- Department of Otorhinolaryngology–Head and Neck Surgery, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Lindsay Bischoff
- Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alexander Langerman
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Young Kim
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
9
|
Alatsakis M, Drogouti M, Tsompanidou C, Katsourakis A, Chatzis I. Invasive Thyroglossal Duct Cyst Papillary Carcinoma: A Case Report and Review of the Literature. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:757-762. [PMID: 29950556 PMCID: PMC6053947 DOI: 10.12659/ajcr.907313] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Female, 27 Final Diagnosis: Invasive thyroglossal duct cyst papillary carcinoma Symptoms: Painless cervical enlargement Medication: — Clinical Procedure: Sistrunk’s procedure Specialty: Surgery
Collapse
Affiliation(s)
- Michael Alatsakis
- Department of Surgery, General Hospital of Thessaloniki, Agios Dimitrios, Thessaloniki, Greece
| | - Maria Drogouti
- Department of Surgery, General Hospital of Thessaloniki, Agios Dimitrios, Thessaloniki, Greece
| | - Chrysoula Tsompanidou
- Department of Pathology, General Hospital of Thessaloniki, Agios Dimitrios, Thessaloniki, Greece
| | - Anastasios Katsourakis
- Department of Surgery, General Hospital of Thessaloniki, Agios Dimitrios, Thessaloniki, Greece
| | - Iosif Chatzis
- Department of Surgery, General Hospital of Thessaloniki, Agios Dimitrios, Thessaloniki, Greece
| |
Collapse
|
10
|
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
| |
Collapse
|
11
|
Aluffi P, Pino M, Boldorini R, Pia F. Papillary Thyroid Carcinoma Identified after Sistrunk Procedure: Report of Two Cases and Review of the Literature. TUMORI JOURNAL 2018; 89:207-10. [PMID: 12841674 DOI: 10.1177/030089160308900221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Thyroglossal duct cysts represent the most common congenital cervical malformations. Carcinomas arising in the thyroglossal duct cysts are rare neoplasms characterized by a relatively non aggressive behavior with rare lymph node spread. Approximately 1% of thyroglossal cysts contain a carcinoma. The most frequent histological type is papillary carcinoma, accounting for about 80% of cases. Currently, most authors agree about their primary origin ex novo from ectopic thyroid tissue in the cyst. In most cases the diagnosis of thyroglossal duct carcinoma (TDC) is not made until histopathological examination has been performed on a resected cyst without any suspected clinical sign of malignancy. The definition of the correct surgical treatment for these carcinomas is still controversial; most authors maintain that resection of a TDC with the Sistrunk procedure can be considered oncologi-cally adequate when dealing with a differentiated carcinoma without extracapsular invasion and/or lymph node metastases and with a normal thyroid. We present two cases of papillary thyroid carcinoma identified after resection of a thyroglossal cyst according to the Sistrunk procedure and managed with different surgical approaches according to the different sites of the tumors. In addition, we discuss appropriate therapeutic strategies in light of the most recent data in the literature.
Collapse
Affiliation(s)
- Paolo Aluffi
- Department of Otorhinolaryngology, University of Piemonte Orientale, Novara, Italy.
| | | | | | | |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Sturniolo G, Vermiglio F, Moleti M. Thyroid cancer in lingual thyroid and thyroglossal duct cyst. ACTA ACUST UNITED AC 2016; 64:40-43. [PMID: 27825535 DOI: 10.1016/j.endonu.2016.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/19/2016] [Accepted: 07/26/2016] [Indexed: 10/20/2022]
Abstract
Ectopy is the most common embryogenetic defect of the thyroid gland, representing between 48 and 61% of all thyroid dysgeneses. Persistence of thyroid tissue in the context of a thyroglossal duct remnant and lingual thyroid tissue are the most common defects. Although most cases of ectopic thyroid are asymptomatic, any disease affecting the thyroid may potentially involve the ectopic tissue, including malignancies. The prevalence of differentiated thyroid carcinoma in lingual thyroid and thyroglossal duct cyst is around 1% of patients affected with the above thyroid ectopies. We here review the current literature concerning primary thyroid carcinomas originating from thyroid tissue on thyroglossal duct cysts and lingual thyroid.
Collapse
Affiliation(s)
- Giacomo Sturniolo
- Dipartimento di Patologia Umana dell'adulto e dell'età evolutiva "Gaetano Barresi", University of Messina, Italy
| | - Francesco Vermiglio
- Dipartimento di Medicina Clinica e Sperimentale, University of Messina, Italy.
| | - Mariacarla Moleti
- Dipartimento di Medicina Clinica e Sperimentale, University of Messina, Italy
| |
Collapse
|
15
|
Al-Thani H, El-Menyar A, Sulaiti MA, El-Mabrok J, Hajaji K, Elgohary H, Asim M, Taha I, Tabeb A. Presentation, Management, and Outcome of Thyroglossal Duct Cysts in Adult and Pediatric Populations: A 14-Year Single Center Experience. Oman Med J 2016; 31:276-83. [PMID: 27403240 DOI: 10.5001/omj.2016.54] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES A thyroglossal duct cyst (TDC) is a frequent congenital midline anomaly of the neck that usually manifests during the first decade of life. We aimed to describe the presentation, management, and outcome of TDC in pediatric and adult cases. METHODS A retrospective observational analysis was conducted for all patients diagnosed and treated for TDC between 2000 and 2014 in a single center in Qatar. Data included patients' demographics, presentations, preoperative investigations, anesthesia type, histopathological findings, surgical management, recurrences, and complications. RESULTS We identified 102 patients, of which 57% were males. The mean age of patients was 20.2±15.6 years. A bimodal distribution of TDC has been observed, which peaked between the ages of 6-13 years and at ≥19 years. The preoperative evaluation mainly includes ultrasonography (66%), thyroid function test (44%), and fine-needle aspiration cytology (10%). The median size of the cyst was 25 (2-60) mm. Patients mainly presented with an asymptomatic midline neck mass at or below the hyoid bone (82%), followed by fistula (9%), infection (2%), and dysphagia (2%). Eighty-nine cases were identified preoperatively as TDC. The histopathological findings confirmed TDC with hyoid bone in 61 cases, and TDC alone in 38 cases. Eighty patients underwent the Sistrunk procedure while excision of TDC alone was observed in 18 cases. Five cases of recurrent disease were also treated. Adults had a greater median cyst size (30 (9-60) vs. 22 (2-55) mm; p = 0.005) and required prolonged operation time (69 (1-169) vs. 32.5 (1-140) mins;
p = 0.004) compared to the pediatric group. CONCLUSION The occurrence of TDC shows a bimodal age distribution. Preoperative evaluation and time for surgery vary whereas clinical presentations, surgical management, and postoperative outcomes are comparable among adult and pediatric groups. Ultrasonography is the preferred diagnostic modality, and the Sistrunk procedure remains the primary choice of treatment.
Collapse
Affiliation(s)
- Hassan Al-Thani
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Ayman El-Menyar
- Clinical Research, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar; Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
| | | | | | - Khairi Hajaji
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Hesham Elgohary
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Asim
- Clinical Research, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar
| | - Ibrahim Taha
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | | |
Collapse
|
16
|
Zizic M, Faquin W, Stephen AE, Kamani D, Nehme R, Slough CM, Randolph GW. Upper neck papillary thyroid cancer (UPTC): A new proposed term for the composite of thyroglossal duct cyst-associated papillary thyroid cancer, pyramidal lobe papillary thyroid cancer, and Delphian node papillary thyroid cancer metastasis. Laryngoscope 2015; 126:1709-14. [PMID: 26691539 DOI: 10.1002/lary.25824] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 11/02/2015] [Accepted: 11/13/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS Thyroglossal duct cyst (TGDC) is a common congenital anomaly, but TGDC carcinoma is rare. Thyroglossal duct cyst carcinoma management is controversial, especially that of the orthotopic thyroid gland. We aim to provide an insight into the pathologic basis of this management controversy through the review of 28 TGDC cancer cases, thus far the largest such series to our knowledge. STUDY DESIGN Retrospective. METHODS Twenty-eight cases recorded as TGDC cancer in the hospital database were reviewed; their initial clinical diagnosis from medical chart review (DX1) and final pathological review diagnosis (DX2) through pathology slides review by our pathologist (blinded to DX1) were compared. The thyroid gland management and pathology were evaluated. RESULTS In the 28 TGDC carcinoma (hospital-recorded diagnosis) patients, DX1 and DX2 were respectively reported as 53% and 14% TGDC carcinoma, 11% and 29% as pyramidal lobe primary, and 4% and 25% as metastatic Delphian node. Thirty-two percent of cases were in the indeterminate category, in both DX1 and DX2, but included different patients. Thyroidectomy was performed in 54% of the cases, papillary thyroid cancer (PTC) was reported in 37% of these thyroid glands. Concurrent thyroid gland malignancy was reported in all Delphian node and pyramidal lobe PTC patients. CONCLUSION The diagnosis of TGDC cancer comprises a heterogeneous group that includes true TGDC cancer, pyramidal lobe primary, Delphian node metastasis, and indeterminate cases. We propose a new terminology of upper neck papillary thyroid carcinoma (UPTC) to denote this heterogeneous group and recommend a rational algorithm for management. Correct pathologic subcategory and thyroid ultrasonography are essential for optimal management of thyroid gland in UPTC cases. LEVEL OF EVIDENCE 4. Laryngoscope, 126:1709-1714, 2016.
Collapse
Affiliation(s)
- Marica Zizic
- Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary & Harvard Medical School, Boston, Massachusetts, U.S.A
| | - William Faquin
- Department of Pathology, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Antonia E Stephen
- Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Dipti Kamani
- Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary & Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Romy Nehme
- Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary & Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Cristian M Slough
- Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary & Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Gregory W Randolph
- Division of Thyroid and Parathyroid Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary & Harvard Medical School, Boston, Massachusetts, U.S.A.,Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts, U.S.A
| |
Collapse
|
17
|
Does Papillary Carcinoma of Thyroglossal Duct Cyst Develop De Novo? Case Rep Otolaryngol 2015; 2015:382760. [PMID: 26351606 PMCID: PMC4553182 DOI: 10.1155/2015/382760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/05/2015] [Indexed: 11/17/2022] Open
Abstract
Backround. Thyroglossal duct cyst (TDC) is a developmental abnormality of the thyroid gland. Due to embryological remnants of thyroid tissue located in the TDC, the same malignant tumors that develop in the thyroid gland can also develop in the TDC. Methods. We present the unique case of a 39-year-old female with simultaneous de novo papillary carcinoma in a TDC and the thyroid gland. Results. With the suspicion of simultaneous papillary carcinoma in the TDC and the thyroid gland, Sistrunk procedure with total thyroidectomy and central neck exploration was performed. Conclusion. The clinician should have a high index of suspicion upon encountering papillary carcinoma of the TDC to differentiate de novo papillary carcinoma in the TDC from those originating from the thyroid gland, because papillary carcinoma in TDC may originate from an occult thyroid papillary carcinoma.
Collapse
|
18
|
Tall cell carcinoma arising in a thyroglossal duct cyst: A case report. Ann Med Surg (Lond) 2015; 4:129-32. [PMID: 25973192 PMCID: PMC4423716 DOI: 10.1016/j.amsu.2015.04.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 04/13/2015] [Accepted: 04/15/2015] [Indexed: 11/30/2022] Open
Abstract
Introduction Thyroglossal duct cyst carcinomas are extremely rare and their clinical presentation is similar to that of benign cysts. The diagnosis is based on physical examination, laboratory tests, and most importantly multiple imaging techniques (ultrasonography, computed tomography and magnetic resonance imaging), and fine needle aspiration cytology. Presentation of case We report a very unusual case of a tall cell variant of papillary carcinoma arising in a thyroglossal duct cyst in association with a follicular variant of papillary microcarcinoma and a tall cell variant of papillary carcinoma arising from the thyroid gland. Discussion Although rarely described in the medical literature, ectopic thyroid tissue present in the thyroglossal duct cyst could be involved in the development of a poorly differentiated carcinoma. The frequent observation of an associated primitive thyroid carcinoma makes surgical management of thyroid gland controversial. Conclusion For the optimal management of this rare pathological condition, a comprehensive preoperative evaluation and meticulous intra-operative appraisal are fundamental. TDCCs are uncommon but usually with a good prognosis. An association with thyroid primitive carcinoma is frequently observed. An extremely rare TDCC variant with a poor prognosis associated with two synchronous foci of thyroid carcinoma is reported. Surgical management of the thyroid gland within treatment plan is controversial. An accurate preoperative evaluation is mandatory for an optimal management.
Collapse
|
19
|
Pietruszewska W, Wągrowska-Danilewicz M, Józefowicz-Korczyńska M. Papillary carcinoma in thyroglossal duct cyst with uninvolved thyroid. Case report and review of the literature. Arch Med Sci 2014; 10:1061-5. [PMID: 25395963 PMCID: PMC4223151 DOI: 10.5114/aoms.2014.46226] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 06/20/2012] [Accepted: 09/10/2012] [Indexed: 11/17/2022] Open
Affiliation(s)
- Wioletta Pietruszewska
- Department of Otolaryngology and Oncological Laryngology, Medical University of Lodz, Lodz, Poland
| | | | | |
Collapse
|
20
|
Carter Y, Yeutter N, Mazeh H. Thyroglossal duct remnant carcinoma: beyond the Sistrunk procedure. Surg Oncol 2014; 23:161-6. [PMID: 25056924 DOI: 10.1016/j.suronc.2014.07.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 06/14/2014] [Accepted: 07/04/2014] [Indexed: 10/25/2022]
Abstract
Thyroglossal duct remnants (TGDRs) account for more than 70% of anterior neck masses in children and 7% in adults; however, cancer is identified in only 1-2% of the cases. The diagnosis of a TGDR is based on clinical manifestation of a painless, anterior neck swelling, which elevates with swallowing. Cytological evaluation with fine needle aspiration and biopsy (FNAB) may facilitate the pre-operative diagnosis of malignancy, as the majority of TGDR cancers are of papillary histotype. The recommended treatment for symptomatic TGDR without evidence of malignancy is a Sistrunk procedure, which entails en bloc resection of the remnant and the mid-portion of the hyoid bone. The optimal management of patients with diagnosed malignancy is controversial, and in the past, additional total thyroidectomy was recommended for all of these patients. The purpose of this study is to review the literature on TGDR carcinomas, present the evidence on the available diagnostic tools, identify the surgical and post-operative medical management strategies, discuss current controversies, and conclude with a management algorithm.
Collapse
Affiliation(s)
- Yvette Carter
- Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA
| | - Nicholas Yeutter
- Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA
| | - Haggi Mazeh
- Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA; Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel.
| |
Collapse
|
21
|
Aculate N, Jones H, Bansal A, Ho M. Papillary carcinoma within a thyroglossal duct cyst: significance of a central solid component on ultrasound imaging. Br J Oral Maxillofac Surg 2014; 52:277-8. [DOI: 10.1016/j.bjoms.2013.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 10/11/2013] [Indexed: 10/26/2022]
|
22
|
Cai Q, Huang X, Liang F, Chen J, Liang M, Pan Y, Zheng Y. Endoscope-assisted concurrent resection of thyroglossal duct cysts and benign thyroid nodules via a small submental incisions. Eur Arch Otorhinolaryngol 2013; 271:1771-5. [PMID: 24081791 DOI: 10.1007/s00405-013-2688-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 09/04/2013] [Indexed: 11/30/2022]
Abstract
The objective of this study was to evaluate the technique of endoscope-assisted concurrent resection of thyroglossal duct cysts and benign thyroid nodules via a small submental incision. Endoscope-assisted thyroglossal duct cyst excision and subtotal thyroidectomy were performed via a small submental incision in six patients with thyroglossal duct cysts and benign nodular thyroid lesions. The thyroglossal duct cysts and thyroid lesions were completely excised. The incisions were 3-4 cm in length, and the mean operation time was 84 ± 11 min. The mean volume of blood loss was 19 ± 5 mL. Postoperative pathological examination findings confirmed the diagnosis of thyroglossal duct cyst in all patients. The thyroid lesions were nodular goiter in three patients and thyroid adenoma in three patients. No postoperative complications such as hematoma, pharyngeal fistula, hypocalcemia, recurrent laryngeal nerve paralysis, or dysphagia were observed. No changes in the planned surgical procedure were required, and no recurrent lesions were detected during follow-up. In conclusion, patients with thyroglossal duct cysts and benign thyroid lesions can be treated by endoscopic excision via a small submental incision, thereby avoiding large neck incisions and resulting in better postoperative cosmetic outcomes.
Collapse
Affiliation(s)
- Qian Cai
- Department of Otolaryngology-Head and Neck, Affiliated Second Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, China,
| | | | | | | | | | | | | |
Collapse
|
23
|
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.
Collapse
Affiliation(s)
- Yun Mi Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Tharmabala M, Kanthan R. Incidental thyroid papillary carcinoma in a thyroglossal duct cyst - management dilemmas. Int J Surg Case Rep 2012; 4:58-61. [PMID: 23124070 DOI: 10.1016/j.ijscr.2012.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 09/24/2012] [Accepted: 10/03/2012] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Benign thyroglossal duct tract remnants typically thyroglossal duct cysts, (TDCs) are one of the commonest congenital childhood midline neck masses. Clinical presentation of persistent TDCs in adults is uncommon and the occurrence of incidental primary thyroid papillary carcinoma (TPC) in these cysts is rare. PRESENTATION OF CASE We report the case of a 32-year-old female with an asymptomatic midline neck mass compatible with a TDC that was excised by Sistrunk's procedure. Histopathological examination revealed an incidental primary intraluminal TPC arising from the wall of the TDC. DISCUSSION Management dilemmas regarding the roles for total thyroidectomy, regional lymph node dissection, radioactive iodine, and suppressive thyroxine therapy are reviewed in the context of relevant evidence based literature. CONCLUSION The occurrence of incidental TPC in a TDC is rare. Though Sistrunk's procedure is adequate treatment for TDC, based on low, moderate, and high risk stratification, recommendations for further management of incidental TPC in TDC is discussed.
Collapse
Affiliation(s)
- Mehala Tharmabala
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Canada.
| | | |
Collapse
|
25
|
Dan D, Rambally R, Naraynsingh V, Maharaj R, Hariharan S. A case of malignancy in a thyroglossal duct cyst--recommendations for management. J Natl Med Assoc 2012; 104:211-4. [PMID: 22774390 DOI: 10.1016/s0027-9684(15)33519-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Thyroglossal duct cyst carcinomas are rare tumors with just more than 200 cases published to date. This is a case report of a thyroglossal duct cyst harboring an occult carcinoma for which a Sistrunk operation was performed. Histopathological examination revealed a papillary carcinoma arising from a thyroglossal duct cyst after which the patient underwent a total thyroidectomy. With current evidence-based guidelines lacking, we discussed some of the issues relevant to the surgical planning and postoperative management of such a patient.
Collapse
Affiliation(s)
- Dilip Dan
- Department of Clinical Surgical Sciences, The University of the West Indies, Champ Fleurs, Trinidad.
| | | | | | | | | |
Collapse
|
26
|
Dzodic R, Markovic I, Stanojevic B, Saenko V, Buta M, Djurisic I, Oruci M, Pupic G, Milovanovic Z, Yamashita S. Surgical management of primary thyroid carcinoma arising in thyroglossal duct cyst: an experience of a single institution in Serbia. Endocr J 2012; 59:517-22. [PMID: 22504175 DOI: 10.1507/endocrj.ej12-0070] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Thyroglossal duct cyst (TDC) carcinoma is a comparable rare entity and treatment strategies have not been standardized. Here, we report a favorable outcome of TDC carcinoma patients based on our therapeutic strategy. Twelve patients with TDC carcinoma treated in our department from 1986 to 2012 were enrolled. Ten patients underwent Sistrunk's procedure in other institutions and referred to our institution for re-operation after the diagnosis of TDC carcinoma and the remaining two underwent initial surgery in our institution. Eleven patients were diagnosed as papillary and one as follicular carcinoma originating from TDC. We performed total thyroidectomy for 11, and limited thyroidectomy for one patient. Three patients (25%) had carcinoma lesions in the thyroid. We routinely dissected level I bilaterally and 6 of 11 patients (55%) with papillary carcinoma-type TDC carcinoma had metastasis. Level II/III nodes were biopsied and if positive, we performed level II-IV dissection. Of the 5 patients positive for level II/III, 2 were also positive for level IV. For the 3 patients with synchronous carcinoma in the thyroid, we performed level VI dissection and two had metastasis in this level. To date, 1 patient showed a recurrence to the lung, but none of the patients in our series died of carcinoma. For surgery of TDC carcinoma, Sistrunk's procedure, total thyroidectomy with level I dissection is mandatory. Whether level II-IV dissection is performed depends on pathology of biopsied level II/III nodes. Level VI dissection is also recommended especially when carcinoma lesions are pre/intra operatively detected in the thyroid.
Collapse
Affiliation(s)
- Radan Dzodic
- School of Medicine University of Belgrade, Serbia.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
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.
Collapse
Affiliation(s)
- Yavuz Albayrak
- Department of General Surgery and Burn Unit, Erzurum Region Education and Research Hospital, Erzurum, Turkey.
| | | | | | | | | |
Collapse
|
28
|
Abstract
Thyroglossal duct cysts are usually located in the midline of the neck. The coexistence of carcinomas in thyroglossal duct cysts is extremely rare, with most being papillary carcinomas. Usually, the diagnosis is only made postoperatively after excision of the cyst. Although the Sistrunk procedure is often regarded as adequate, controversies exist concerning the need for thyroidectomy depending on histopathological findings. We report the case of a 31-year-old man diagnosed with papillary carcinoma within a thyroglossal duct cyst, who underwent total thyroidectomy as has been recommended for differentiated papillary cancer.
Collapse
Affiliation(s)
- N Balalaa
- Department of Surgery, Tawam Hospital in Affiliation with Johns Hopkins Medicine, Al Ain, United Arab Emirates
| | | | | | | |
Collapse
|
29
|
Park MH, Yoon JH, Jegal YJ, Lee JS. Papillary thyroglossal duct cyst carcinoma with synchronous occult papillary thyroid microcarcinoma. Yonsei Med J 2010; 51:609-11. [PMID: 20499433 PMCID: PMC2880280 DOI: 10.3349/ymj.2010.51.4.609] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This is a case report on papillary thyroglossal duct cyst (TGDC) carcinoma along with synchronous occult papillary thyroid microcarcinoma. A 46-year-old woman visited our hospital because she had an anterior midline neck mass below her hyoid bone. Preoperative ultrasound-guided fine-needle aspiration cytology revealed signs of papillary TGDC carcinoma. We performed a Sistrunk operation and a total thyroidectomy. Histopathological examination of the specimen revealed papillary carcinoma arising in the TGDC and papillary microcarcinoma of the thyroid gland without extrathyroidal extension. Surgeons should be aware of TGDC carcinoma during surgical planning and postoperative treatment and should differentiate this carcinoma from an anterior midline neck mass.
Collapse
Affiliation(s)
- Min-Ho Park
- Department of General Surgery, Chonnam National University Hwasun Hospital, Hwasun-eup, Hwasun, Korea.
| | | | | | | |
Collapse
|
30
|
Cherian MP, Nair B, Thomas S, Somanathan T, Sebastian P. Synchronous papillary carcinoma in thyroglossal duct cyst and thyroid gland: Case report and review of literature. Head Neck 2009; 31:1387-91. [DOI: 10.1002/hed.21029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
31
|
Abstract
Authors present a rare case of the papillary thyroid carcinoma in thyroglossal duct cyst in a 40 year-old woman. Preoperative assessment (palpation and ultrasonography) showed symptoms of typical thyroglossal duct cyst and the final diagnosis was established after histopathological examination of the surgical specimen. Epidemiology, diagnostic methods and treatment of this rare disease were also discussed in the study.
Collapse
|
32
|
Dib N, Benhammou A, Meziane M, Harmouch A, Nazih N, Essakali L, Kzadri M, Sefiani S. [Papillary adenocarcinoma on ectopic thyroid tissue]. ACTA ACUST UNITED AC 2009; 126:65-70. [PMID: 19296927 DOI: 10.1016/j.aorl.2009.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 02/09/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To report a case of papillary adenocarcinoma occurring on ectopic thyroid tissue in the hyoid bone region. MATERIAL AND METHODS A 57-year-old patient consulted for a cervical mass appearing 1 year before, with no signs of compression. The thyroid function was normal. RESULTS The examination showed a firm tumefaction, fixed on the hyoid bone, with undetermined limits, measuring approximately 8 cm. The thyroid gland was in the normal pretracheal position. The cervical tomodensitometry objectified an osteolytic process centered on the hyoid bone with a fleshy zone of tissue density and calcifications. Cervical MRI provided a more precise assessment of the extension of the mass and confirmed the integrity of the other structures, in particular the endo-larynx. The tumor was totally resected via a cervical approach. The pathologic study suggested a papillary adenocarcinoma on ectopic thyroid tissue. The treatment was completed by a total thyroidectomy with normal histological results. CONCLUSIONS Papillary adenocarcinoma on ectopic thyroid is a very rare situation. Its diagnosis is histological. Its treatment is primarily surgical, sometimes associated with radioiodine I-131 therapy.
Collapse
Affiliation(s)
- N Dib
- Service d'ORL et de chirurgie cervicofaciale, hôpital des spécialités, CHU de Rabat-Salé, Rabat, Maroc.
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Berni Canani F, Dall'Olio D, Chiarini V, Casadei GP, Papini E. Papillary carcinoma of a thyroglossal duct cyst in a patient with thyroid hemiagenesis: effectiveness of conservative surgical treatment. Endocr Pract 2009; 14:465-9. [PMID: 18558601 DOI: 10.4158/ep.14.4.465] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe a case of thyroglossal duct cyst carcinoma that arose in a patient with right thyroid lobe hemiagenesis. METHODS We present the imaging, physical examination findings, treatment, and clinical course of the study patient. RESULTS A 35-year-old woman was evaluated for a neck mass that had been present for 6 months and was slowly growing. She reported a previous diagnosis of right hemithyroid agenesis. The patient's preoperative workup included ultrasonography of the neck and head and neck T1- and T2-weighted magnetic resonance imaging, which showed right hemithyroid agenesis and a cystic lesion in the median region of the neck below the hyoid bone. Findings from chest x-rays and thyroid function tests were normal. The patient underwent a modified Sistrunk procedure that included removal of the median portion of the hyoid bone. Histologic findings showed a 2.5-cm thyroglossal duct cyst with a 0.6-cm focus of follicular variant of papillary carcinoma with invasion of the cyst wall. Total thyroidectomy was not performed because of the absence of tumoral invasion of the parenchyma around the thyroglossal duct cyst and because the patient was at low risk for aggressive disease. Cervical ultrasonography examinations were performed 6, 12, and 24 months after treatment, and all findings were normal. Presently, the patient is symptom-free after 4 years of follow-up and has no evidence of disease. CONCLUSION Incidentally discovered, well-differentiated thyroid cancer that is confined to a thyroglossal duct cyst in a patient at low risk for aggressive disease can be adequately treated by a modified Sistrunk procedure that includes the median portion of the hyoid bone.
Collapse
|
34
|
Gebbia V, Di Gregorio C, Attard M. Thyroglossal duct cyst carcinoma with concurrent thyroid carcinoma: a case report. J Med Case Rep 2008; 2:132. [PMID: 18445281 PMCID: PMC2387158 DOI: 10.1186/1752-1947-2-132] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2007] [Accepted: 04/29/2008] [Indexed: 11/22/2022] Open
Abstract
Introduction Thyroglossal duct carcinoma is a very rare finding and its presentation is similar to that of a benign cyst, which is a relatively common developmental abnormality that may manifest as a midline, neck mass. In general the diagnosis of thyroglossal duct carcinoma is based on the pathologic examination of the mass, but needle aspiration cytology, ultrasound and computed tomography play a role in the differential diagnosis of malignancy. Case presentation A further case of thyroglossal duct carcinoma and concurrent thyroid carcinoma with locoregional lymph node metastases affecting a 40-year-old woman followed up for 4 years is presented and discussed. Conclusion Sistrunk's surgical technique must always be the initial treatment, but in case of carcinoma further surgery, that is, thyroidectomy with or without lymph node dissection, and treatment with radioactive iodine have to be considered according to the microscopic and clinical findings. Accurate pre-operative clinical and radiological evaluation should be performed in order to plan surgical strategy.
Collapse
Affiliation(s)
- Vittorio Gebbia
- Department of Experimental Oncology and Clinical Applications, University of Palermo, Italy.
| | | | | |
Collapse
|
35
|
Imaging of cystic or cyst-like neck masses. Clin Radiol 2008; 63:613-22. [PMID: 18455551 DOI: 10.1016/j.crad.2007.12.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2007] [Revised: 12/10/2007] [Accepted: 12/14/2007] [Indexed: 11/23/2022]
Abstract
Cystic or cyst-like neck masses form a unique category within head and neck radiology with unique differential diagnoses. The precise anatomical location and imaging appearances are important for accurate diagnosis and formulating the differential diagnoses of cystic lesions in the neck. In vast majority of cases ultrasound, sometimes supplemented by fine-needle aspiration cytology (FNAC), is adequate for pre-treatment assessment. For large, deep-seated lesions assessment using magnetic resonance imaging (MRI) or computed tomography (CT) often provides useful supplementary information. Radiologists should be aware of imaging findings of common cystic neck masses to help in their appropriate management.
Collapse
|
36
|
Mondin V, Ferlito A, Muzzi E, Silver CE, Fagan JJ, Devaney KO, Rinaldo A. Thyroglossal duct cyst: personal experience and literature review. Auris Nasus Larynx 2007; 35:11-25. [PMID: 17720342 DOI: 10.1016/j.anl.2007.06.001] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Accepted: 06/19/2007] [Indexed: 10/22/2022]
Abstract
The thyroglossal duct cyst [TDC, or thyroglossal tract remnant (TTR)] is a well recognized developmental abnormality which arises in some 7% of the population. As a consequence, it represents the most common type of developmental cyst encountered in the neck region. It typically presents as a mobile, painless mass in the anterior midline of the neck, usually in close proximity to the hyoid bone. Less often, TDCs may present with signs and symptoms of secondary infection, or with evidence of a fistula. While TDCs are most often diagnosed in the pediatric age group, a substantial minority of patients with TDCs are over 20 years of age at the time of diagnosis. The standard surgical approach to TDC, encompassing removal of the mid-portion of the hyoid bone in continuity with the TDC and excision of a core of tissue between the hyoid bone and the foramen cecum, dates back to the late 19th and early 20th centuries and is often referred to as Sistrunk's operation. Malignancy is rarely encountered in TDCs; when such rare tumors do develop (in the order of 1% or so of patients with TDCs), they usually take the form of either papillary carcinoma of thyroid origin, or squamous carcinoma.
Collapse
Affiliation(s)
- Vanni Mondin
- Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy
| | | | | | | | | | | | | |
Collapse
|
37
|
Kermani W, Belcadhi M, Abdelkéfi M, Bouzouita K. Papillary carcinoma arising in a thyroglossal duct cyst: case report and discussion of management modalities. Eur Arch Otorhinolaryngol 2007; 265:233-6. [PMID: 17668227 DOI: 10.1007/s00405-007-0405-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2006] [Accepted: 07/11/2007] [Indexed: 11/25/2022]
Abstract
A case of papillary carcinoma arising in the wall of a thyroglossal duct cyst is described. These cancers are very rare and rather adult-specific. Preoperative diagnosis may be enhanced using fine-needle aspiration cytology and computing tomography findings. The standard treatment of thyroglossal duct cyst carcinoma is the sistrunk procedure. The concept of prognostic risk groups should be used to identify patients who would additionally undergo total thyroidectomy.
Collapse
Affiliation(s)
- Wassim Kermani
- Department of Otorhinolaryngology, Head and Neck Surgery, Hôpital Universitaire Farhat Hached, Service d'ORL, Avenue Ibn Eljazzar, Sousse, Tunisia
| | | | | | | |
Collapse
|
38
|
Plaza CPR, López MED, Carrasco CEG, Meseguer LM, Perucho ADLF. Management of well-differentiated thyroglossal remnant thyroid carcinoma: time to close the debate? Report of five new cases and proposal of a definitive algorithm for treatment. Ann Surg Oncol 2006; 13:745-52. [PMID: 16538412 DOI: 10.1245/aso.2006.05.022] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Accepted: 11/04/2005] [Indexed: 11/18/2022]
Abstract
BACKGROUND Thyroid carcinoma is diagnosed in approximately 1% to 2% of thyroglossal duct remnants (TGDR). No definite agreement exists concerning the management of TGDR carcinoma, especially regarding the role of total thyroidectomy and postoperative adjuvant therapy. We report five new cases of TGDR carcinoma and review relevant articles in an attempt to clarify this issue. METHODS We studied the demographic, clinical, tumor-related, treatment, pathologic, and outcome data on five patients treated at our institution for a TGDR carcinoma and compared the results with the four most important series published. RESULTS All five patients were women, and diagnosis occurred after surgery in four. The sizes of the papillary tumors were 40, 38, 25, 23, and 15 mm (mean, 28.2 mm; range, 15-40 mm). Fine-needle aspiration biopsy of the TGDR had a low sensitivity (positive for one in four). A Sistrunk procedure was performed for resection of the TGDR in four patients, and plain TGDR resection was performed for the other patient. Three patients underwent repeat surgery; total thyroidectomy was performed in all cases, and cervical bilateral node dissection was performed in one case. With a median follow-up of 123.8 months (range, 8-284 months), all the patients are alive and free of disease, with no recurrences. CONCLUSIONS TGDR carcinoma is a rare malignant tumor that is usually diagnosed after surgery; papillary carcinoma is the most common type. The currently recommended treatment is a Sistrunk procedure, with a tendency to deferred total thyroidectomy in selected cases (similar criteria exist for papillary carcinoma of the thyroid gland). The prognosis is excellent, with a good long-term survival.
Collapse
Affiliation(s)
- César P Ramírez Plaza
- Department of Digestive and General Surgery, Regional University Hospital of Málaga Carlos Haya, Avenida de Carlos Hayas/n. C.P., Málaga, 29010, Spain.
| | | | | | | | | |
Collapse
|
39
|
Ahuja AT, Wong KT, King AD, Yuen EHY. Imaging for thyroglossal duct cyst: the bare essentials. Clin Radiol 2005; 60:141-8. [PMID: 15664568 DOI: 10.1016/j.crad.2004.08.009] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2004] [Revised: 08/12/2004] [Accepted: 08/16/2004] [Indexed: 11/25/2022]
Abstract
Thyroglossal duct cyst is the most common congenital cyst in the head and neck, and imaging features have been well documented in the literature. However, there are several practical important points to bear in mind during preoperative imaging, which are often overlooked. This review aims to summarize the imaging findings and emphasize important points for trainees and radiologists, particularly those who may encounter this lesion infrequently.
Collapse
Affiliation(s)
- A T Ahuja
- Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong SAR.
| | | | | | | |
Collapse
|
40
|
El Bakkouri W, Racy E, Vereecke A, Gauthier A, Quillard J, Bobin S, Portier F. Carcinome épidermoïde sur kyste du tractus thyréogosse. ACTA ACUST UNITED AC 2004; 121:303-5. [PMID: 15711485 DOI: 10.1016/s0003-438x(04)95525-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To present a case of squamous cell carcinoma developed on a thyroglossal duct cyst in an adult patient. Modalities of treatment and prevention are discussed. PATIENT AND METHODS A 55-year-old woman had a thyroglossal duct cyst since childhood. Surgical resection had not been performed because of parental refusal. RESULTS Diagnosis of malignant degeneration was suggested by an increase in volume associated with cervical pain. Surgery was incomplete because of carotid artery and laryngeal involvement. Postoperative radiotherapy was given. At two years follow-up, local progression was controlled by palliative chemotherapy. DISCUSSION For most authors, the risk of recurrent infections is the main reason for surgical resection of a thyroglossal duct cyst during childhood. The risk of malignant degeneration is generally not put forward. It is rather uncommon for carcinoma to develop on a thyroglossal duct cyst. The risk is probably underestimated because surgery is generally performed early in childhood. CONCLUSION This observation of malignant degeneration emphasizes the importance of surgical resection of thyroglossal duct cysts during childhood. We discuss treatment in the event of malignant degeneration.
Collapse
Affiliation(s)
- W El Bakkouri
- Service d'ORL et de Chirurgie Cervico-Faciale, CHU de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France
| | | | | | | | | | | | | |
Collapse
|
41
|
Belnoue A, Poupart M, Pignat JC. Intérêt de la thyroïdectomie dans la prise en charge des kystes du tractus thyréoglosse dégénérés. ACTA ACUST UNITED AC 2004; 129:523-5. [PMID: 15556584 DOI: 10.1016/j.anchir.2004.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE OF STUDY To discuss the authors' experience with thyroglossal duct (TD) carcinoma and expose the interest of the thyroidectomy in the management of this entity. PATIENTS AND METHODS A retrospective review of all patients with the diagnosis of TD operated on from 1985 to 2002 was performed. RESULTS Four cases of papillary TD carcinoma were identified. Two patients were treated by a Sistrunk procedure associated with total thyroidectomy. One patient needed a thyroidectomy fifteen years after the initial management of the papillary thyroglossal duct carcinoma. The last patient had a medical treatment, with no evidence of complication after eleven years of follow up. CONCLUSION A microscopic focus of papillary carcinoma, without cyst wall invasion, can be managed by a Sistrunk procedure, with the need for long-term follow up. Treatment of all other thyroglossal duct papillary carcinomas should include thyroidectomy followed by radioactive iodine treatment.
Collapse
Affiliation(s)
- Al Belnoue
- Hôpital de la Croix-Rousse, rue Henon, 6900 Lyon, France.
| | | | | |
Collapse
|
42
|
Peretz A, Leiberman E, Kapelushnik J, Hershkovitz E. Thyroglossal duct carcinoma in children: case presentation and review of the literature. Thyroid 2004; 14:777-85. [PMID: 15361266 DOI: 10.1089/thy.2004.14.777] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Carcinoma within the thyroglossal duct (TGDCa) is a very rare pediatric tumor. This report presents the case of a 15-year-old girl with TGDCa, reviews the previously published pediatric cases of this tumor, and provides diagnostic and therapeutic considerations in TGDCa in children. Twenty one cases of TGDCa have been reported, 12 of them in females. Mean age at presentation was approximately 13 years for females and approximately 12 years for males. The duration of a midcervical mass prior to the diagnosis of TGDCa varied from 3 weeks to 8 years. The size of the neck mass at presentation averaged 2 cm-4 cm. All masses were asymptomatic, and the diagnosis of TGDCa was incidental following surgery. All pediatric cases of TGDCa reported thus far were of the papillary type, except for 3 patients who presented with a mixed papillary-follicular carcinoma. Capsular invasion was detected in 10 (45%) patients. Local invasive disease was found in 5 (23%) patients, but all removed thyroid glands (12) were free of carcinoma. One patient had lung metastases. Thyroidectomy with subsequent radioiodine ablation was the treatment of choice in the majority of the cases. The reported prognosis for TGDCa in children was favorable, with only one reported death.
Collapse
Affiliation(s)
- Asaf Peretz
- Pediatric Department, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | | | | | | |
Collapse
|
43
|
Abstract
The incidence of Papillary Thyroid Carcinoma in a Thyroglossal Cyst is rare. Only about 160 cases have been reported in the last 85 years. We report a case of Thyroglossal Cyst who underwent Sistrunk ’s Operation. The Cyst was reported to contain a focus of papillary thyroid carcinoma. In the absence of metastases in thyroid gland and neck nodes, only thyroid suppression with Thyroxine was given. After I year of follow-up there are no metastases. The importance of Sistrunk’s operation lies not only in complete removal of Thyroglossal Cyst but also in management of small foci of Papillary thyroid Carcinoma.
Collapse
|
44
|
Dedivitis RA, Camargo DL, Peixoto GL, Weissman L, Guimarães AV. Thyroglossal duct: a review of 55 cases. J Am Coll Surg 2002; 194:274-7. [PMID: 11893130 DOI: 10.1016/s1072-7515(01)01171-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Thyroglossal duct remnants are the most common midline neck masses in childhood but can be found in adults and the elderly. Sistrunk's procedure, with dissection of the tract and removal of the hyoid bone, is accepted as the main operation of choice. STUDY DESIGN Fifty-five patients were treated from January 1994 to November 2000, and these were studied. There were 29 men and 26 women, with a median age of 17 years. Diagnosis was clinical, with 13 cases of fistula and 42 of cyst. Size varied from 1.0 to 4.0 cm, with an average of 2.5 cm. Six patients presented with local abscess. RESULTS All the patients underwent Sistrunk's procedure. Serum collection occurred in three patients as complication. In one patient papillary carcinoma was identified in the cyst. Total thyroidectomy was not performed. There was only one recurrence, managed with a second operation. CONCLUSIONS We concluded that the diagnosis of thyroglossal duct is clinical. Sistrunk's procedure carries low rates of complications (9.08%) and recurrence (1.82%). Antibiotic therapy is avoidable as a rule and hospital stay is short.
Collapse
|
45
|
Moncet D, Manavela M, Cross GE, Cazado E, Soutelo J, Elsner B, Niepomniszcze H. Papillary carcinoma in thyroglossal duct cyst. Endocr Pract 2001; 7:463-6. [PMID: 11747284 DOI: 10.4158/ep.7.6.463] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To report the management and outcome of three cases of papillary carcinoma (PC) in thyroglossal duct cysts (TGCs). METHODS We present case reports of one female and two male patients between the ages of 22 and 46 years who had TGCs. In addition, we discuss the theories about the pathogenesis of TGC carcinoma (de novo versus metastatic lesions). RESULTS In all three patients, we found a TGC that contained a vegetating mass. Subsequent pathologic examination revealed the presence of a PC. All patients underwent total thyroidectomy, and two of them concurrently had PC in the thyroid gland. Besides the PC in the TGC, the first patient had a "cold" scintigraphic thyroid nodule that was also a PC, whereas the second patient had a thyroid microcarcinoma that had not been detected before surgical intervention. The third patient did not have carcinoma of the thyroid, but the histologic pattern of the gland resembled that observed in de Quervain's disease. We interpreted this finding as "palpation thyroiditis." The patients received postoperative 131I and suppressive therapy with levothyroxine. During a follow-up period of 2 to 12 years (mean, 5.8), we found no recurrence of the disease, and serum thyroglobulin remained undetectable in all cases. CONCLUSION Although use of total thyroidectomy followed by radioiodine therapy and suppressive treatment with levothyroxine is a matter of debate in patients with PC in TGCs, we conclude that this approach yields a favorable outcome in most cases, especially when the thyroid is also involved by the PC, and allows a better postoperative follow-up.
Collapse
Affiliation(s)
- D Moncet
- Division of Endocrinology, Hospital de Clínicas, José de San Martín School of Medicine, University of Buenos Aires, Argentina
| | | | | | | | | | | | | |
Collapse
|
46
|
Montero García C, Keituqwa Yáñez T, Alvarez Domínguez J, Marqués Rebollo L, Blasco Huelva A. [Papillary carcinoma on thyroglossal duct cyst]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2001; 52:75-8. [PMID: 11269884 DOI: 10.1016/s0001-6519(01)78181-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Papillary carcinoma ansing on a thryroglosal duct cyst is a rare tumor. Since Ucherman described first case in 1915, only 150 cases have been reported. We present clinic evolution and treatment of a new case and review literature and discussion about tumor origin, adequate diagnosis test and treatment. This should include Sistrunk procedure but further surgery on thyroid gland is not accepted by all authors.
Collapse
Affiliation(s)
- C Montero García
- Servicio Orl, Hospital Regional Universitario Infanta Cristina, Badajoz
| | | | | | | | | |
Collapse
|
47
|
Abstract
Thyroglossal duct cysts (TGDCs) are common, however, a malignancy occurring in a TGDC is rare. The presence on an underlying malignancy is clinically occult but may be detected on preoperative imaging studies. We describe the CT findings of a papillary carcinoma occurring in a TGDC.
Collapse
Affiliation(s)
- S Datar
- Department of Radiology, King Edward Memorial Hospital, Bombay, India
| | | | | | | |
Collapse
|
48
|
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.
Collapse
Affiliation(s)
- Y J Yang
- Departments of Pathology, SUNY Health Science Center at Syracuse, Syracuse, NY 13210, USA
| | | | | | | |
Collapse
|