Papillary Carcinoma Arising From Thyroglossal Duct Cysts: A Case Series and Management Strategies

Papillary carcinoma arising from thyroglossal duct cysts is a rare entity, most often detected after surgery. Despite its excellent prognosis, management remains controversial. In this report, we present three cases of papillary carcinoma in thyroglossal duct cysts. In two of the three cases, malignancy was identified in both the thyroglossal duct cyst and the thyroid gland at the time of presentation. In contrast, the third case was diagnosed with malignancy only after surgery for the thyroglossal duct cyst, ultimately necessitating a total thyroidectomy. A high degree of suspicion and clinical awareness are required during evaluation of this rare situation which is otherwise usually a benign lesion. For low-risk patients with papillary carcinoma involving only the thyroglossal duct cyst, the Sistrunk procedure (resection of the thyroglossal duct cyst) is adequate. For high-risk cases of papillary carcinoma of the thyroglossal duct cyst with an associated malignancy of the thyroid gland, total thyroidectomy, central compartment nodal dissection, and radioactive iodine ablation are needed.