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Papillary thyroid carcinoma in thyroglossal duct cyst
1Department of Otorhinolaryngology and Head and Neck Surgery, Universidade Metropolitana de Santos UNIMES, SP, Brazil. r.dedivitis@bsnet.com.br
International Surgery
|April 28, 2001
Summary
Thyroglossal duct cysts are common, but carcinoma is rare. Surgical excision (Sistrunk procedure) is standard, and papillary carcinoma can be treated effectively with thyroxine suppression, preserving the thyroid gland.
Area of Science:
- Head and Neck Surgery
- Endocrinology
- Surgical Pathology
Background:
- Thyroglossal duct remnants are the most frequent midline neck masses.
- Malignancy within these remnants is uncommon, occurring in about 1% of cases.
- Papillary adenocarcinoma is the predominant histological subtype.
Observation:
- A 36-year-old woman presented with a thyroglossal cyst.
- Pre-operative and intra-operative assessments revealed no thyroid abnormalities.
- Histopathological examination post-Sistrunk procedure confirmed papillary carcinoma.
Findings:
- Thyroglossal duct carcinoma is a rare clinical entity.
- Pre-operative ultrasonography is recommended for thyroid gland evaluation.
- Papillary carcinoma of the thyroglossal duct cyst has a high cure rate (95%) with thyroid preservation.
Implications:
- Controversy exists regarding concurrent thyroidectomy for thyroglossal duct carcinoma.
- Thyroid hormone suppression therapy is crucial for all patients.
- The Sistrunk procedure, typically used for benign cysts, may be optimal for thyroglossal duct carcinoma, avoiding additional morbidity.