Incidental Thyroglossal Duct Cyst Papillary Thyroid Carcinoma: A Scoping Review

The incidental finding of papillary thyroid carcinoma (PTC) within thyroglossal duct cysts (TGDCs) represents an uncommon, yet significant finding, with its management remaining controversial.

We performed a scoping review of PTC within TGDCs per PRISMA guidelines (PROSPERO registration CRD42022341179) to determine its prevalence, investigate the likelihood of thyroid and lymphatic involvement and prognosis to better inform management.

EMBASE/OvidMEDLINE/CochraneEBM Reviews/PubMed were searched, with results reviewed by two authors independently for inclusion. Case series including three or more patients with TDGC PTC published between January 1993 to April 2025 were eligible for inclusion. The quality and bias of each included article were assessed with the JBI Critical Appraisal Tool. Demographics, surgical/medical treatment, presence of concomitant thyroid malignancy, nodal disease, recurrence and survival were extracted on an individual level where available and analysed. Subgroup analyses comparing PTC in TGDC only versus TGDC and thyroid gland were also performed.

Three hundred and fifty-three patients were identified from 33 included studies. There was a female predominance (n = 236, 66.9%), compared to males (n = 116, 32.9%). The mean age was 41.1 years. Histologically, tumour sizes ranged from 1 to -100 mm. 342 (96.9%) patients had classic/typical PTC. One hundred and twenty-seven patients (36.0%) had concomitant thyroid PTC, and 89 (25.2%) had lymph node metastasis. Of those 89, 21 (23.6%) had central neck involvement only, 31 (34.8%) had lateral neck involvement only and 12 (13.5%) had both.

Patients with PTC in TGDC are typically female in their fifth decade of life. Thyroid involvement is demonstrated in over a third of cases, with lymph node involvement in over a quarter.