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Papillary carcinoma in a thyroglossal duct cyst: Two case reports and review of literature

Year 2012, Volume: 34 Issue: 1, 107 - 112, 27.03.2012

Abstract

Abstract

Thyroglossal duct cysts are the most common form of congenital malformation in the neck. They develop from the epithelial remnants of the thyroglossal tract and 70% is diagnosed in childhood; 7% is diagnosed in adulthood. Carcinoma arising in these remnants constitutes a very uncommon histopathological entity. The diagnosis of malignancy is made incidentally on cytopathologic studies of the excised surgical specimen. Only 1% of thyroid carcinoma arises from the thyroglossal duct cysts and papillary carcinoma (80%) is the most common malignancy in this cyst. We describe here two cases of thyroglossal duct cysts. Surgical specimen histopathology study showed presence of papillary carcinoma in the first case. Thyroglossal duct cyst was preoperatively diagnosed via fine needle aspiration biopsy (FNAB) in the second case. We suggest that in adult cases of thyroglossal duct cysts, fine needle aspiration cytology should be used for preoperative diagnosis and frozen examination should be done intra operatively.

Keywords: Thyroglossal ductus cyst, papillary thyroid carcinoma, fine needle aspiration biopsy, diagnosis, treatment

 

Özet

Tiroglossal duktus kisti, boyun orta hattında en sık görülen konjenital boyun kitlesidir. Tiroglossal duktusun epitelyal kalıntılarından gelişir ve %70 çocuk yaş grubunda %7 ise erişkin yaşlarda tanı alır. Tiroglossal kanal kistinden karsinoma gelişimi oldukça nadirdir. Malignite eksize edilen cerrahi spesimenin histolojik incelemesinde tesadüfen saptanır. Tiroglossal kanal kistinde karsinom gelişimi oldukça nadirdir ve olguların %1’inden azında gözlenir ve papiller karsinoma (%80) bu kistlerde en sık izlenen malignensidir. Bu çalışmada cerrahi spesmenin histopatolojik incelemesi ile postoperatif dönemde ve preoperatif dönemde ince iğne aspirasyon biopsisi ile tiroglossal kist de papiller tiroid karsinomu tanısı almış olan iki olgumuzu sunduk. Erişkin yaş grubunda tiroglosal kanal kisti tanısı almış olan olgularda preoperatif ince iğne biyopsisi ve intraoperatif frozen çalışılması gerektiği kanısındayız.

Anahtar sözcükler: Tiroglossal kanalkisti, papillar tiroid karsinoma, ince iğne aspirasyon biyopsisi, tanı, tedavi

References

  • Peretz A, Leiberman E, Kapelushnik J, Hershkovitz E: Thyroglossal duct carcinoma in children: Case presentation and review of the literature. Thyroid 2004; 14: 777-85.
  • Vincent S, Synhorst II J: Adenocarcinoma arising in a thyroglossal duct cyst. J. Oral Maxillofac Surg 1989; 47: 633-5.
  • Aydin O: Boyun kitleleri. Kulak Burun Bogaz Hastalıkları ve Baş-Boyun cerrahisi. 1 baskı. Editör: Koc C, Ankara: Güneş Kitabevi; 2004: 887-99.
  • Plaza CP, Lopez ME, Carrasco CE, Meseguer LM, Perucho Ade L: Management of well differentiated thyroglossal remnant thyroid carcinoma: time to close the debate? Report of five new cases and proposal of a definitive algorithm for treatment. Ann Surg Oncol 2006; 13: 745-52.
  • Geok Chin T, Mohd Sidik Sh, Manickam S, Seng Phang K, Clarence-Ko CH, Jeevanan J: Papillary carcinoma of the thyroglossal duct cyst in a 15-year-old girl. Int J Otorhinolaryngology 2007; 2: 732-5.
  • Yang YJ, Haghir S, Wanamaker JR, Powers CN. Diagnosis of papillary carcinoma in a thyroglossal duct cyst by fine-needle aspiration biopsy. Arch Pathol Lab Med 2000; 124: 139-42.
  • Tehrani AN, Karimi YAR, Kazemi M. Primary papillary carcinoma in thyroglossal duct cyst. Acta Medica Iranica 2007; 45: 236-8.
  • Agarwal K, Puri V, Singh S. Critical appraisal of FNAC in the diagnosis of primary papillary carcinoma arising in thyroglossal cyst: A case report with review of the literature on FNAC and its diagnostic pitfalls. J Cytol 2010; 27: 22- 5.
  • Park MH, Yoon JH, Jegal YJ, Lee JS. Papillary thyroglossal duct cyst carcinoma with synchronous occult papillary thyroid microcarcinoma. Yonsei Med J 2010; 51: 609-11.
  • Ishay A, ElmalahI, Luboshitzky R: Papillary carcinoma in a thyroglossal duct cyst. IMAJ 2008; 10: 312-3.
  • Srinivasan R, Ranjini K, Vadhiraja BM. Primary papillary carcinoma of the thyroglossal duct cyst - a case report. Indian J Pathol Microbiol 2005; 48: 228-30.
  • Patel SG, Escrig M, Shaha AR, Singh B, Shah JP: Management of well- differentiated thyroid carcinoma presenting within a thyroglossal duct cyst. J Surg Oncol 2002; 79: 134-9.
  • Vijay R, Rajan KK, Feroze M: Inapparent twin malignancy in thyroglossal cyst: Case Report. World J Surg Oncol 2003; 1: 15.
  • Bardales RH, Suhrland MJ, Korourian S, Schaefer RF, Hanna EY, Stanley MW. Cytologic findings in thyroglossal duct carcinoma. Am J Clin Pathol 1996; 106: 615-9.
  • Cherian MP, Nair B, Thomas S, Somanathan T, Sebastian P. Synchronous papillary carcinoma in thyroglossal duct cyst and thyroid gland: case report and review of literature. Head Neck 2009; 31: 1387-91.
  • Miccoli P, Pacini F, Basolo S, Iacconi P, Puccini M, Pinchera A. Thyroid carcinoma in a thyroglossal duct cyst: tumor resection alone or a total thyroidectomy? Ann Chir 1998; 52: 452-4.
  • Kazemi M, Assadi m, Kazemi AA, Ghazvini LA: Primary papillary carcinoma of thyroglossal duct cyst. Hell J Nucl Med 2006; 9: 39-40.
  • Basu S, Shet T, Borges A M: Letter to Editor: Outcome of primary papillary carcinoma of thyroglossal duct cyst with local infiltration to soft tissues and uninvolved thyroid. Indian Journal of Cancer 2009; 46: 169-70.
  • Motamed, Mehdi; McGlashan, Julian A: Thyroglossal duct carcinoma. Current Opinion in Otolaryngology & Head and Neck Surgery 2004; 2: 106-9.
Year 2012, Volume: 34 Issue: 1, 107 - 112, 27.03.2012

Abstract

Tiroglossal duktus kisti, boyun orta hattında en sık görülen konjenital boyun kitlesidir. Tiroglossal duktusun epitelyal kalıntılarından gelişir ve %70 çocuk yaş grubunda %7 ise erişkin yaşlarda tanı alır. Tiroglossal kanal kistinden karsinoma gelişimi oldukça nadirdir. Malignite eksize edilen cerrahi spesimenin histolojik incelemesinde tesadüfen saptanır. Tiroglossal kanal kistinde karsinom gelişimi oldukça nadirdir ve olguların %1’inden azında gözlenir ve papiller karsinoma (%80) bu kistlerde en sık izlenen malignensidir. Bu çalışmada cerrahi spesmenin histopatolojik incelemesi ile postoperatif dönemde ve preoperatif dönemde ince iğne aspirasyon biopsisi ile tiroglossal kist de papiller tiroid karsinomu tanısı almış olan iki olgumuzu sunduk. Erişkin yaş grubunda tiroglosal kanal kisti tanısı almış olan olgularda preoperatif ince iğne biyopsisi ve intraoperatif frozen çalışılması gerektiği kanısındayız

References

  • Peretz A, Leiberman E, Kapelushnik J, Hershkovitz E: Thyroglossal duct carcinoma in children: Case presentation and review of the literature. Thyroid 2004; 14: 777-85.
  • Vincent S, Synhorst II J: Adenocarcinoma arising in a thyroglossal duct cyst. J. Oral Maxillofac Surg 1989; 47: 633-5.
  • Aydin O: Boyun kitleleri. Kulak Burun Bogaz Hastalıkları ve Baş-Boyun cerrahisi. 1 baskı. Editör: Koc C, Ankara: Güneş Kitabevi; 2004: 887-99.
  • Plaza CP, Lopez ME, Carrasco CE, Meseguer LM, Perucho Ade L: Management of well differentiated thyroglossal remnant thyroid carcinoma: time to close the debate? Report of five new cases and proposal of a definitive algorithm for treatment. Ann Surg Oncol 2006; 13: 745-52.
  • Geok Chin T, Mohd Sidik Sh, Manickam S, Seng Phang K, Clarence-Ko CH, Jeevanan J: Papillary carcinoma of the thyroglossal duct cyst in a 15-year-old girl. Int J Otorhinolaryngology 2007; 2: 732-5.
  • Yang YJ, Haghir S, Wanamaker JR, Powers CN. Diagnosis of papillary carcinoma in a thyroglossal duct cyst by fine-needle aspiration biopsy. Arch Pathol Lab Med 2000; 124: 139-42.
  • Tehrani AN, Karimi YAR, Kazemi M. Primary papillary carcinoma in thyroglossal duct cyst. Acta Medica Iranica 2007; 45: 236-8.
  • Agarwal K, Puri V, Singh S. Critical appraisal of FNAC in the diagnosis of primary papillary carcinoma arising in thyroglossal cyst: A case report with review of the literature on FNAC and its diagnostic pitfalls. J Cytol 2010; 27: 22- 5.
  • Park MH, Yoon JH, Jegal YJ, Lee JS. Papillary thyroglossal duct cyst carcinoma with synchronous occult papillary thyroid microcarcinoma. Yonsei Med J 2010; 51: 609-11.
  • Ishay A, ElmalahI, Luboshitzky R: Papillary carcinoma in a thyroglossal duct cyst. IMAJ 2008; 10: 312-3.
  • Srinivasan R, Ranjini K, Vadhiraja BM. Primary papillary carcinoma of the thyroglossal duct cyst - a case report. Indian J Pathol Microbiol 2005; 48: 228-30.
  • Patel SG, Escrig M, Shaha AR, Singh B, Shah JP: Management of well- differentiated thyroid carcinoma presenting within a thyroglossal duct cyst. J Surg Oncol 2002; 79: 134-9.
  • Vijay R, Rajan KK, Feroze M: Inapparent twin malignancy in thyroglossal cyst: Case Report. World J Surg Oncol 2003; 1: 15.
  • Bardales RH, Suhrland MJ, Korourian S, Schaefer RF, Hanna EY, Stanley MW. Cytologic findings in thyroglossal duct carcinoma. Am J Clin Pathol 1996; 106: 615-9.
  • Cherian MP, Nair B, Thomas S, Somanathan T, Sebastian P. Synchronous papillary carcinoma in thyroglossal duct cyst and thyroid gland: case report and review of literature. Head Neck 2009; 31: 1387-91.
  • Miccoli P, Pacini F, Basolo S, Iacconi P, Puccini M, Pinchera A. Thyroid carcinoma in a thyroglossal duct cyst: tumor resection alone or a total thyroidectomy? Ann Chir 1998; 52: 452-4.
  • Kazemi M, Assadi m, Kazemi AA, Ghazvini LA: Primary papillary carcinoma of thyroglossal duct cyst. Hell J Nucl Med 2006; 9: 39-40.
  • Basu S, Shet T, Borges A M: Letter to Editor: Outcome of primary papillary carcinoma of thyroglossal duct cyst with local infiltration to soft tissues and uninvolved thyroid. Indian Journal of Cancer 2009; 46: 169-70.
  • Motamed, Mehdi; McGlashan, Julian A: Thyroglossal duct carcinoma. Current Opinion in Otolaryngology & Head and Neck Surgery 2004; 2: 106-9.
There are 19 citations in total.

Details

Primary Language English
Journal Section Case Reports
Authors

Emine Altuntaş

Şahande Elagöz

Ersin Tuncer

Ayhan Koyuncu

Suphi Müderris

Publication Date March 27, 2012
Published in Issue Year 2012Volume: 34 Issue: 1

Cite

AMA Altuntaş E, Elagöz Ş, Tuncer E, Koyuncu A, Müderris S. Papillary carcinoma in a thyroglossal duct cyst: Two case reports and review of literature. CMJ. March 2012;34(1):107-112.