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Deepthi S, Bishnoi T, Sahu PK, Dogra N, Paramasivam PK. Synchronous Carcinoma in Thyroglossal Cyst: A Rare Occurrence. Indian J Otolaryngol Head Neck Surg 2023; 75:3843-3846. [PMID: 37974759 PMCID: PMC10646088 DOI: 10.1007/s12070-023-03808-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/10/2023] [Indexed: 11/19/2023] Open
Abstract
A Thyroglossal cyst is a commonly encountered clinical entity resulting due to the persistence of the thyroglossal duct and the transformation of a few embryonic cells into a cyst. The incidence of malignant change in the thyroglossal cyst is reported as between 1 to 1.8 percent. Here we present a case report of a male who presented with swelling in the neck, on ultrasonography (USG) found to be a thyroglossal cyst, fine needle aspiration cytology (FNAC) suggested a papillary carcinoma within the thyroglossal cyst. Total thyroidectomy with bilateral selective neck dissection, central compartment clearance, and sistrunk operation were done. The histopathological report revealed papillary carcinoma of the thyroid within a thyroglossal cyst with neck nodal metastasis.
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Affiliation(s)
| | - Tapasya Bishnoi
- Department of ENT-HNS, Command Hospital Airforce, Bangalore, India
| | | | - Natasha Dogra
- Department of Laboratory Medicine, Command Hospital Airforce, Bangalore, 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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Rumman AMA, Alsoudi MA, Qasimeh HM, Alnajada WA, Al Shunnaq RY. Isolated poorly differentiated cancer (insular) in a thyroglossal cyst: a case report. Pan Afr Med J 2021; 39:254. [PMID: 34707755 PMCID: PMC8520425 DOI: 10.11604/pamj.2021.39.254.30317] [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: 06/12/2021] [Accepted: 08/13/2021] [Indexed: 11/11/2022] Open
Abstract
A 23-year-old young man presented with a painless neck mass that he noticed slowly growing over the past 4 years. Neck imaging showed an irregular 5 x 5 cm mixed solid and cystic mass in mid neck that looked suspicious but normal looking thyroid and no neck lymphadenopathy. Thyroid uptake scan was within normal also. Fine needle biopsy (FNA) from thyroglossal cyst (TGC) was malignant, Bethesda VI. Multi-disciplinary meeting discussed the case and advised for removal of both the TGC cancer and total thyroidectomy. After patient counseling, he underwent Sistrunk procedure for excision of the TGC mass and total thyroidectomy. histopathological examination revealed a poorly differentiated carcinoma of insular type in TGC with unremarkable thyroid gland. Patient recovery was uneventful. Post-operative multi-disciplinary meeting discussed the histopathology results and advised for post-operative radioactive iodine therapy (RAI) and thyroxine suppression followed by serum thyroid stimulating hormone (TSH) and thyroglobulin (TG). We shall review the diagnostic and management considerations of our case having this rare cancer.
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Kartini D, Panigoro SS, Harahap AS. Sistrunk Procedure on Malignant Thyroglossal Duct Cyst. Case Rep Oncol Med 2020; 2020:6985746. [PMID: 32395358 PMCID: PMC7201451 DOI: 10.1155/2020/6985746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/16/2019] [Accepted: 01/06/2020] [Indexed: 11/17/2022] Open
Abstract
A thyroglossal duct cyst is a lesion that occurs as a result from failure of the thyroglossal duct to obliterate during fetal development. Malignant progression is a rare event that might occur in less than 1% of all cases. Because of its rarity, there are conflicting opinions regarding the management of the case. In the present study, a 46-year-old male presented with a painless neck mass that had increased in size over the last 6 months. There was no difficulty in swallowing and breathing, change in voice, significant weight loss, or any signs of hyperthyroidism. Laboratory workup showed that results were within normal limits. Thyroid gland ultrasonography and cervical contrast CT scan revealed a complex cystic mass that pointed towards a thyroglossal duct cyst. We performed Sistrunk procedure. Postoperative pathology examination revealed microscopic appearance of the thyroglossal duct cyst with a classic follicular variant of papillary thyroid carcinoma. Our latest follow-up showed no signs of tumor recurrence or any complications following surgery on locoregional status. As a fine needle aspiration biopsy cannot ensure a precise result in all of cases, it is essential to perform a solid physical examination and thorough supporting examination in deciding the precise management for the patient.
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Affiliation(s)
- Diani Kartini
- Oncology Division, Department of Surgery, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Sonar S. Panigoro
- Oncology Division, Department of Surgery, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Agnes S. Harahap
- Department of Anatomical Pathology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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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
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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
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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
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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
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Rayess HM, Monk I, Svider PF, Gupta A, Raza SN, Lin HS. Thyroglossal Duct Cyst Carcinoma: A Systematic Review of Clinical Features and Outcomes. Otolaryngol Head Neck Surg 2017; 156:794-802. [DOI: 10.1177/0194599817696504] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective Although thyroglossal duct cysts (TGDCs) are relatively common, malignancies within these lesions are infrequent. As a result, there are no large-scale series describing clinical characteristics. Our objectives were to perform a systematic review of the literature evaluating patient demographics, pathology, management, and prognosis of these patients. Data Sources PubMed, Embase, Cochrane reviews, and Google Scholar were searched for relevant articles. Articles meeting inclusion criteria were reviewed for data detailing epidemiology, treatment, and outcomes. Review Methods Inclusion criteria included English-language articles with original reports on human subjects. Two investigators independently reviewed all articles for the data collected, including epidemiology, treatment, and outcomes. Results Ninety-eight articles comprising 164 patients were included in the final analysis. The mean age at presentation was 39.5 years (9-83 years); 68.3% of patients were female. In total, 73.3% of cases were found on final pathologic analysis. The most common pathology was papillary cancer (92.1%). Of the patients, 98.9% underwent a Sistrunk procedure and 61.0% underwent total thyroidectomy. There was a 4.3% recurrence rate with a mean time to recurrence of 42.1 months from initial treatment. One patient died of TGDC carcinoma, while all other patients were disease free at the time of last follow-up (mean follow-up was 46.1 months). Conclusion TGDC carcinoma is typically diagnosed on final pathology. While management encompasses a Sistrunk procedure, further consideration should be given to thyroidectomy among patients ≥45 years of age and individuals with aggressive disease. TGDC carcinoma harbors an exceedingly low rate of mortality.
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Affiliation(s)
- Hani M. Rayess
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Ian Monk
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Peter F. Svider
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Amar Gupta
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - S. Naweed Raza
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
- Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Ho-Sheng Lin
- Department of Otolaryngology–Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
- Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
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Simultaneous Papillary Carcinoma in Thyroglossal Duct Cyst and Thyroid. Case Rep Endocrinol 2017; 2017:8541078. [PMID: 28270939 PMCID: PMC5320317 DOI: 10.1155/2017/8541078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 01/10/2017] [Indexed: 11/17/2022] Open
Abstract
Thyroglossal duct cyst (TDC) is a cystic expansion of a remnant of the thyroglossal duct tract. Carcinomas in the TDC are extremely rare and are usually an incidental finding after the Sistrunk procedure. In this report, an unusual case of a 36-year-old woman with concurrent papillary thyroid carcinoma arising in the TDC and on the thyroid gland is presented, followed by a discussion of the controversies surrounding the possible origins of a papillary carcinoma in the TDC, as well as the current management options.
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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.
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A case report of papillary thyroid carcinoma arising from a thyroglossal duct cyst and brief literature review. Pathology 2015. [DOI: 10.1097/01.pat.0000461475.74429.3d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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