Papillary thyroglossal duct carcinoma: report of nine cases and review of literature

Abstract

Background: Thyroglossal duct carcinoma (TDCa) is a rare malignancy. Thus, we summarized the clinical characteristics of TDCa to explore the strategy of diagnosis, surgical treatment, and prognosis of patients with papillary TDCa.

Case presentation: A retrospective study was conducted about the medical records of cases with TDCa. General information including the diagnosis, surgical treatment, and prognosis of patients were obtained and analyzed. A total of 480 patients with thyroglossal duct anomalies were treated in our hospital during 1981 to 2011. Nine patients were identified as papillary TDCa and Sistrunk procedure was performed in these patients. Total thyroidectomy and selected neck dissection were performed in 3 TDCa patients with additional multiple thyroid nodules at presentation, of whom one was diagnosed as papillary thyroid carcinoma and another was found to have lymph node metastases. With a median follow-up of 119 months, all patients were alive with no recurrences or metastases.

Conclusions: Although the incidence of TDCa is very low, early diagnosis and surgical operation of TDCa should be performed as soon as possible. Besides, the pathological examination is the only way to confirm the diagnosis, and surgery, especially Sistrunk's procedure, is the prior choice of the treatments. In the presence of thyroid lesions or cervical lymphadenopathy, total thyroidectomy and neck dissection should be considered.

Keywords: Papillary thyroglossal duct carcinoma; diagnosis; head and neck neoplasms; treatment.

Figure 1

Histopathology results of papillary TDCa. A. Microscopic examination shows typically slender arborizing papillae formations (H&E, 60 ×). B. Ground glass nuclear (short arrow) and nuclear groove (long arrow; H&E, 400 ×).

Figure 2

Immunohistochemical staining of papillary TDCa tissues. The brown granule staining indicates a positive reaction for each protein (arrows; 400 ×). A. Thyroid protein; B. Thyroid transcription factor-1; C. Galectin-3.