Follicular adenoma in a juxtathyroidal thyroglossal duct cyst with papillary carcinoma in the adjacent thyroid gland

This patient presented with a neck mass diagnosed as a papillary thyroid carcinoma by fine-needle aspiration. Preoperative computed tomography revealed a papillary carcinoma within a juxtathyroidal thyroglossal duct cyst. After surgery, the initial diagnosis was papillary thyroid carcinoma. After correlation with the computed tomography, the diagnosis was revised to a papillary thyroid carcinoma plus a follicular adenoma in a juxtathyroidal thyroglossal duct cyst. This case demonstrates the need for close clinical and radiographic correlation in such a complex case.     

Simultaneous papillary carcinoma in a thyroglossal duct remnant and the thyroid gland

BACKGROUND: In 1 % of the thyroglossal duct cysts malignant transformation is found with predomination of the papillary carcinoma (80 %). CASE REPORT: We present the case of a 51 year old man with a synchronic papillary carcinoma in a thyroglossal duct remnant and a microcarcinoma of the thyroid gland. After exstirpation of a thyroglossal duct cyst histological examination identified a papillary carcinoma. Postoperative staging uncovered enlarged lymph nodes but no abnormalities in the thyroid gland. Cervical lymphadenectomy and total thyroidectomie was performed. On histological examination a synchronic microcarcinoma of the thyroid was shown. CONCLUSION: Only 7 similar cases have been published in literature before. Because of the rare incidence no therapeutic standard could be established so far. We discuss our therapeutic approach as well as the relevant literature.     

Thyroglossal duct carcinoma: A rational approach to management

Objective: To discuss the authors' experience with thyroglossal duct carcinoma and present a rational approach to the management of this entity. Study Design and Methods: A retrospective review of the cytopathology and pathology records of all patients with the diagnosis of a thyroglossal duct remnant from 1965 to 1997 was performed. Results: Three cases of papillary thyroglossal duct carcinoma were identified, with one suspected squamous cell carcinoma by needle aspiration. The papillary carcinomas are discussed in detail to illustrate the difficulty encountered in managing the thyroid gland in the setting of a thyroglossal duct carcinoma. Fine-needle aspiration proved effective in making the diagnosis preoperatively. Conclusions: The authors recommend that a thyroglossal duct cyst with a microscopic focus of papillary carcinoma, without cyst wall invasion, be managed with a Sistrunk procedure. Treatment of all other thyroglossal duct papillary carcinomas should include removal of all thyroid tissue followed by radioactive iodine treatment.     

甲状舌管癌1例并文献复习

目的〓〖HTK〗探讨甲状舌管癌的诊断及治疗方法。〖HTW〗方法〓〖HTK〗回顾性分析1例甲状舌管癌患者病历资料,结合复习相关文献,对甲状舌管癌的起源、诊断及治疗方法进行讨论。〖HTW〗结果〓〖HTK〗甲状舌管癌多为乳头状癌,颈部CT有多囊结构、囊壁实性结节或钙化表现。〖HTW〗结论〓〖HTK〗甲状舌管癌临床罕见,囊肿迅速长大、颈部CT表现和细针穿刺是术前诊断的重要依据,Sistrunk术式是有效的原发灶切除方法。     

Terminal duct adenocarcinomas of salivary tissues

Terminal duct adenocarcinoma is recommended as an encompassing diagnostic designation for a preponderantly intraoral salivary gland carcinoma that has also gone under the names of polymorphous low-grade adenocarcinoma, lobular carcinoma, and low-grade papillary adenocarcinoma. The carcinoma is biologically low grade, with its papillary phenotype manifesting a more aggressive behavior than nonpapillary forms.     

甲状舌管癌的临床诊治并文献复习（附2例报告）

目的通过对甲状舌管癌患者的诊断和治疗,并复习相关文献,总结该病的临床特征和准确制定合理的治疗方案。方法报道2例甲状舌管癌患者的诊治过程,影像学特点及治疗方法。结果2例患者术前均被误诊为甲状舌管囊肿,常规行Sistrunk手术,术后病检1例为甲状舌管乳头状癌,另1例为甲状腺乳头状癌,结合术中所见最后诊断为甲状腺舌管乳头状癌,2例术后复查甲状腺功能均正常,复查甲状腺超声未见明显恶性肿瘤特征,均未行甲状腺手术治疗,1例未做任何其他补充治疗,随访8年无局部复发和转移,另1例行甲状腺素抑制治疗随访1年无复发。结论甲状腺舌管癌临床罕见,术前易误诊为甲状舌管囊肿,术前超声及增强CT有助于诊断,需病理确诊,手术方案的制定需综合考虑,病理分型决定其预后。     

Papillary carcinoma from the thyroglossal duct cyst: review of the literature and report of a case

Cancer of a thyroglossal duct cyst is very rare. Clinical presentation is identical that of a benign cyst, and the diagnosis is histopathological. We report the case of 36 year-old woman treated for papillary carcinoma of a thyroglossal duct cyst. The treatment was surgical excision according Sistrunk method. There was no distant spread. After 22 months follow up, the patient is alive, with no signs of recurrence.     

Ectopic thyroid carcinoma lacking a thyroglossal duct cyst in the submental portion: a case report

Ectopic thyroid carcinomas in the submental portion arise usually from a thyroglossal duct cyst. We report a rare case of that lacking a thyroglossal duct cyst. The patient, a 32 year-old man, had two submental tumors with good mobility. CT, MRI, and US revealed two solid tumors. Fine needle aspiration cytology (FNAC) suggested thyroid papillary carcinoma metastasis. The thyroid gland itself showed normal morphology. The submental tumors were extirpated. Pathological examination revealed ectopic normal thyroid tissue and papillary carcinoma. As the edge of the extirpated tumor showed positive papillary carcinoma cells, reoperation was performed to remove the residual tumor using Sistrunk's technique. To the best of our knowledge, this is the 45th case of ectopic thyroid carcinoma with no thyroglossal duct cyst and second case of that in the submental portion in the English and Japanese literature. FNAC was the most important to diagnose and differentiate the submental tumors.     

Squamous cell carcinoma arising in a thyroglossal duct cyst.

Carcinoma arising in a thyroglossal duct cyst is a rare event, occurring in less than 1% of abnormalities of the thyroglossal duct. To date, there have been approximately 100 cases reported, with papillary carcinoma accounting for the vast majority. Squamous cell carcinoma, on the other hand, is an even rarer event. Its clinical course in the elderly, consisting of recurrent drainage and suppuration, may distinguish it from other neoplastic conditions of thyroglossal duct cyst. We present a 65-year-old man with squamous cell carcinoma in a recurrently discharging thyroglossal duct cyst to illustrate important distinguishing clinical features of this condition.     

Salivary duct carcinoma with comedonecrosis in the mobile portion of the tongue

We present a patient suffering from salivary duct carcinoma in the mobile portion of the tongue, arising from a minor salivary gland; this condition is extremely rare. The patient was a 64-year-old woman who presented with a nonpainful, hard mass in her tongue. An aspiration smear showed cells with very scant cytoplasm and pale oval nuclei containing small, single nucleoli. Scattered clusters of small cells had darkly stained nuclei. Neither necrosis nor cribriform areas were seen. The smears suggested a salivary gland neoplasm; however, definitive diagnosis of salivary duct carcinoma remained difficult. Partial glossectomy was performed with a wide margin. Macroscopic examination revealed an unencapsulated, submucosal tumour infiltrating underlying muscle. Microscopic examination revealed a salivary duct carcinoma with comedonecrosis and relatively few cribriform and papillary areas. This case suggests that it may not be easy to establish a definitive diagnosis of salivary duct carcinoma from an aspiration smear if the salivary duct carcinoma is composed of comedonecrosis surrounded by solid tissue in a noncribriform pattern.     

Thyroglossal duct papillary carcinoma in a 15-year old female and review of pediatric cases of thyroglossal duct carcinoma

Thyroglossal duct carcinoma is rare, occurring in approximately 1% of thyroglossal duct cysts. Excluding this case report there have been 25 cases of adolescent thyroglossal duct carcinoma reported in the English literature thus far. Most of the pathology reported has been papillary or follicular carcinoma, leading to the question of whether or not to perform concurrent thyroidectomy. Based on our review of the pediatric cases of thyroglossal duct carcinoma we elected not to perform a concurrent thyroidectomy and recommend close follow-up to monitor for signs of future thyroid involvement.     

Papillary thyroid carcinoma in a thyroglossal duct cyst: primary tumor or metastasis?

Thyroglossal duct cysts are the most common anomaly in thyroid development. The occurrence of carcinoma in a cyst is reported to be about 1% of cases. Histopathological examinations reveal a papillary thyroid carcinoma in about 94% of these. We report the case of 38-year-old female having a massive, cervical cystic mass over a period of 18 months. An ectopic papillary thyroid carcinoma was diagnosed. A total thyoidectomy and bilateral neck dissection were performed. This revealed a small thyroid carcinoma and three positive lymphatic nodes. Whether the cystic carcinoma is the primary or a metastasis of the thyroid carcinomais discussed.     

Carcinoma arising in thyroglossal remnants

Three patients with a papillary carcinoma arising in a thyroglossal duct cyst are presented and the literature is reviewed. This rare malignancy is seen mostly in women between the ages of 20 and 50 years. The distribution of carcinoma subtypes differs from that of thyroid carcinomas and thyroglossal duct carcinoma is recognized as a primary tumour. The diagnosis is seldom made pre-operatively though especially in older patients with midline swellings in the neck the diagnosis should be considered. Sistrunk's operation is the treatment of choice. In this operation the cyst, the middle part of the hyoid bone and the thyroglossal duct are removed in continuity.     

Papillary carcinoma in a thyroglossal duct remnant

For papillary carcinoma in a thyroglossal duct remnant, complete wide excision of the remnant is adequate treatment.     

Presentations of thyroglossal duct cysts in adults

The thyroglossal duct cyst is the most common congenital neck mass, resulting from persistence and dilatation of remnants of an epithelial tract formed during migration of the thyroid during embryogenesis. Approximately 7% of the population has thyroglossal duct remnants. Although thyroglossal duct cysts generally present clinically in children, it is important to understand that the lesion can present in adults as well, sometimes much later in life. Incidental carcinoma of the thyroglossal duct cyst is rare, but is more likely to occur in adults than children. Between 1991 and 1998, 11 cases of thyroglossal duct cysts were seen in adult patients at Georgetown University Medical Center, including 2 cases containing papillary carcinoma. This report discusses their clinical presentations and management. Received: 11 September 1998 / Accepted: 23 October 1998     

Unusual CT appearance of a thyroglossal duct cyst carcinoma

This is the first report to describe the CT appearances of a solid midline cervical mass that proved to be a papillary carcinoma associated with a thyroglossal duct cyst.     

Duct carcinoma of the minor salivary glands: a case report

A tumour was removed from the oral vestibule of a 62-year-old woman. It showed histological features of both salivary duct carcinoma and papillary adenocarcinoma. The possibility that these entities might be but varieties of duct adenocarcinoma is suggested.     

Papillary carcinoma arising in a thyroglossal duct cyst: case report and discussion of management modalities

A case of papillary carcinoma arising in the wall of a thyroglossal duct cyst is described. These cancers are very rare and rather adult-specific. Preoperative diagnosis may be enhanced using fine-needle aspiration cytology and computing tomography findings. The standard treatment of thyroglossal duct cyst carcinoma is the sistrunk procedure. The concept of prognostic risk groups should be used to identify patients who would additionally undergo total thyroidectomy.     

Sarcomatoid salivary duct carcinoma of the larynx

The sarcomatoid variant is a rare subtype of salivary duct carcinoma that comprises epithelial and sarcomatoid components. The authors present the first reported case of sarcomatoid salivary duct carcinoma occurring in the larynx, which was successfully treated by partial laryngectomy with ipsilateral neck dissection, with no evidence of recurrence after five years. Microscopic analysis revealed a composite epithelial and sarcomatoid tumour. The epithelial component was characterized by papillary proliferation of glandular and ductal structures lined with multilayered epithelial tumour cells. The sarcomatoid component was characterized by pleomorphic spindle cells with cytologic atypia, accompanied by small lymphoid cells, extensive proliferation of blood vessels and focal myxoid changes. To the best of our knowledge, only one case of sarcomatoid salivary duct carcinoma outside a major salivary gland has been reported previously in the literature, and this is the first report of sarcomatoid salivary duct carcinoma arising from the larynx.     

A case of bilateral cervical lymph node metastasis of thyroglossal duct cancer

We reported a case of thyroglossal duct cancer, which metastasized to the bilateral cervical lymph nodes. The cervical lymph node metastases were detected in the upper portion of the neck. According to the results obtained in the preoperative fine needle aspiration cytology, the lymph node metastases were classified as group V and a diagnosis of papillary carcinoma was made. The preoperative studies with 123I revealed no concentration in the submittal tumor. In our surgical procedure, bilateral supraomohyoid neck dissection was added to excision of the tumor. CONCLUSION: In view of the fact that thyroglossal duct cancer metastasized bilaterally to cervical lymph nodes in the present case, we experienced an extremely rare case.