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.     

Papillary thyroid carcinoma in a thyroglossal cyst

The incidence of Papillary Thyroid Carcinoma in a Thyroglossal Cyst is rare. Only about 160 cases have been reported in the last 85 years. We report a case of Thyroglossal Cyst who underwent Sistrunk ’s Operation. The Cyst was reported to contain a focus of papillary thyroid carcinoma. In the absence of metastases in thyroid gland and neck nodes, only thyroid suppression with Thyroxine was given. After I year of follow-up there are no metastases. The importance of Sistrunk’s operation lies not only in complete removal of Thyroglossal Cyst but also in management of small foci of Papillary thyroid Carcinoma.     

Papillary carcinoma on thyroglossal duct cyst

Papillary carcinoma ansing on a thryroglosal duct cyst is a rare tumor. Since Ucherman described first case in 1915, only 150 cases have been reported. We present clinic evolution and treatment of a new case and review literature and discussion about tumor origin, adequate diagnosis test and treatment. This should include Sistrunk procedure but further surgery on thyroid gland is not accepted by all authors.     

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.     

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.     

Papillary carcinoma of the thyroglossal duct cyst in childhood

Thyroglossal duct carcinoma is a rare malignancy that is usually diagnosed postoperatively. Approximately 150 cases have been reported in the literature. Eighty-five percent of these were papillary carcinomas. Controversies exist concerning its nature and treatment. In this report, we present an 11-year-old boy with an anterior cervical cystic mass originating in the thyroglossal duct. After a primary Sistrunk procedure, the cyst and tract extending to the foramen caecum at the base of the tongue in continuity with the midportion of the hyoid bone were resected. Histopathologic study demonstrated a papillary carcinoma. After 4 months of follow-up, the patient is asymptomatic without any evidence of recurrence. The clinical and histopathological features and therapeutic options are discussed.     

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.     

Intra-thyroid thyroglossal duct cyst as a differential diagnosis of thyroid nodule

An intra-thyroid thyroglossal duct cyst (ITTDC) presented as a congenital anterior neck mass in a 10-year-old male. Diagnosis, work-up, management approach, and differential diagnosis of thyroid nodules are discussed, as well as distinguishing features between thyroglossal duct cyst (TDC) and branchial cleft cyst (BCC). This is the fourth case of ITTDC reported in the pediatric population, and ITTDC should remain in the differential diagnosis of pediatric neck mass.     

Concurrent lingual thyroid and undescended thyroglossal duct thyroid without orthotopic thyroid gland

Thyroglossal duct cyst and lingual thyroid are two common anomalies of thyroid gland development. Each may occur without the thyroid gland in the normal anatomic position, although the association of these three anomalies together is rare. Ectopic thyroid may function abnormally, and this determination can help guide surgical management. Therefore, early evaluation by an endocrinologist is an important part of the therapeutic approach. We report on the presentation and management of a 14‐year‐old girl with multiple foci of thyroid ectopia, absent orthotopic thyroid gland, and hypothyroidism. Laryngoscope, 2009     

Evaluation and management of a carcinoma arising in a thyroglossal duct cyst

Thyroglossal duct remnants are the most common congenital cystic lesions of the neck; however, a carcinoma arising in these structures is rare. Two new cases of a papillary adenocarcinoma arising in a thyroglossal duct cyst are presented. Preoperative evaluation, operative management, and postoperative care are discussed. Initial evaluation consisting of a thorough head and neck examination, palpation of the thyroid gland, thyroid function tests, and selective use of thyroid imaging is recommended. Removal of the cyst and tract in the manner described by Sistrunk is advocated. If an adenocarcinoma is found in the cyst and if a carcinoma is found in the thyroid gland or a thyroid scan reveals a nodule, a total thyroidectomy is recommended. A modified neck dissection and total thyroidectomy is advocated for cervical metastases. Postoperatively, thyroid suppression and long-term follow-up are encouraged. A squamous cell carcinoma arising in a thyroglossal duct remnant appears more aggressive and requires complete excision and, for confirmed cervical metastases, radical neck dissection and postoperative radiation therapy.     

Nonpigmented papillary carcinoma in a black thyroid gland

A case of papillary thyroid carcinoma occurring in a 27-year-old man with black thyroid syndrome is reported. The tumor, in contrast to the remaining thyroid, was not pigmented. The significance and potential utility of the differential pigmentation are discussed.     

Psammomatous calcification in association with a benign thyroglossal duct cyst

Embryologic remnants of thyroid tissue often line the thyroglossal duct tract and may commonly become cystic. Calcification in such a cyst is thought to be a specific marker for malignancy, which may develop in 1% of thyroglossal duct cysts. We describe a 3-year-old boy with a midline neck mass that showed radiologic calcification. Pathologic evaluation revealed psammomatous calcification in association with a benign thyroglossal duct cyst. These findings, not previously reported (to our knowledge), expand the radiologic differential diagnosis of calcified neck masses and broaden the spectrum of pathologic findings seen in association with benign thyroglossal duct cysts.     

Hyalinizing trabecular adenoma versus papillary thyroid carcinoma in a child

The unusual occurrence of an otic capsule fracture with preservation of hearing is presented. In addition, the patient suffered facial paralysis beginning 6 days after the injury that rapidly recovered. Fifteen-month follow-up reveals stable hearing thresholds. The course of a fracture through the inner ear could be an important factor in determining the potential for hearing preservation.