Incidental papillary thyroid carcinoma in thyroglossal duct cyst case report

Abstract

Introduction: The thyroglossal cyst is found in 7% of the population and the incidental papillary thyroid carcinoma in thyroglossal cyst is a rare entity with an incidence 1 to 2%. The clinical presentation is indistinguishable from a benign lesion and the histopathological postoperative study defines the diagnosis. Papillary carcinomas have favorable prognosis and cervical or distant metastases are rare. There is now a consensus on the indication of total thyroidectomy, radioablation with iodine and/or suppressive therapy with levothyroxine after being removed surgically [1-3] (Patrucco et al., 2015; Gupta et al., 2014; Choi et al., 2013).

Case report: 46-year-old female patient with an asymptomatic midline neck mass consistent with a thyroglossal cyst. That was excised by Sistrunk's procedure and an intraoperative biopsy that reports papillary carcinoma infiltrating the capsule. It was decide to complete the total thyroidectomy without complications, evolution is consistent and graduated euphonious and no evidence of hypoparathyroidism.

Discussion: Management dilemmas regarding the roles for total thyroidectomy are reviewed in the context of relevant evidence based literature.

Conclusion: The initial evaluation of carcinoma of thyroglossal duct cyst includes careful examination, ultrasound and biopsy fine needle aspiration. Sistrunk's procedure is adequate treatment for thyroglossal cyst but find another diagnosis as papillary thyroid carcinoma makes us continue with a total thyroidectomy after discuss the case with experts [4,5] (Tharmabala and Kanthan, 2013; Miranda-Aguirre et al., 2008).

Keywords: Oncology surgery; Papillary carcinomas; Thyroglossal cyst.

Fig. 1

a–b (Complete specimen was sent for histopathological examination).

Fig. 2

a–d (Biopsy report revealed fibrocollagenic wall like tissue along with skeletal muscle bundles showing areas of fibrosis and many foci of papillary tumor lined with cuboidal epithelial cells with numerous Psammoma bodies. Papillary carcinoma infiltrates the thyroid capsule).