Synchronous Thyroglossal Duct Cyst with Thyroid Papillary Carcinoma: An Optimal Management

Park, Il Ho; Lee, Jung Kyu; Jung, Kwang Yoon; Woo, Jeong Soo

Abstract

Thyroglossal duct cyst is the most common congenital neck mass, resulting from the persistence and dilatation of epithelial tract remnants formed during migration of the thyroid during embryogenesis. Approximately 7% of the population has thyroglossal duct remnants and 50% of such thyroglossal duct contains thyroid tissue. It is estimated that carcinoma is found in approximately 1% of thyroglossal duct cyst. We report a 28-year-old female who presented with left thyroid nodule incidentally found in ultrasonography. Ultrasonography and Computed tomography showed small nodular mass with calcification in the left thyroid lobe. Aspirated specimen of mass suggested malignant cells of papillary carcinoma. Since extrathyroidal extension of thyroid papillary carcinoma was noted during the operation, we preferred total thyroidectomy and anterior neck dissection. During the operation, we incidentally found thyroglossal duct cyst. It was resected by the usual Sistrunk's procedure. Histologic sections showed thyroglossal tract lined with pseudostratified columnal epithelium and thyroid follicles in the cyst wall. This case highlights the importance of intraoperative evaluation on the account of the possible presence of thyroglossal duct cyst during total thyroidectomy for malignancy, not only for postoperative radioactive iodine ablation therapy but also to prevent carcinoma from thyroglossal duct cyst.