Cancer in thyroglossal duct cysts

Area of Science:

• Endocrine Surgery
• Head and Neck Oncology
• Diagnostic Cytopathology

Background:

• Thyroglossal duct cysts (TDC) are common midline neck swellings, but carcinoma within them (TDCC) is rare.
• Previous reports suggest TDCC occurs in approximately 1% of TDCs.

Purpose of the Study:

• To determine the incidence of TDCC.
• To evaluate the accuracy of fine needle aspiration cytology (FNAC) for TDCC diagnosis.
• To identify predictive ultrasound (USG) features of TDCC.

Main Methods:

• A cross-sectional study analyzed 86 patients who underwent surgery for TDC between 2001 and 2021.
• Preoperative ultrasound (USG) and FNAC data were reviewed.

Main Results:

• Six cases (7%) of TDCC, specifically papillary thyroid cancer (PTC), were identified, a higher incidence than previously reported.
• USG revealed solid nodules within the cyst wall in five TDCC cases.
• FNAC of these nodules showed malignancy in one and suspicious for malignancy in two cases.

Conclusions:

• The incidence of TDCC is higher than the 1% typically cited.
• Preoperative USG and FNAC targeting solid components are recommended for TDCC evaluation.
• Total thyroidectomy is favored for all TDCC patients.