Papillary Carcinoma of a Thyroglossal Duct Cyst in a Patient with Thyroid Hemiagenesis: Effectiveness of Conservative Surgical Treatment |
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| Institution: | 1. Otolaryngology Department, Maggiore Hospital, Bologne, Italy;2. Endocrine Unit, Maggiore Hospital, Bologne, Italy;3. Anatomical Pathology, Maggiore Hospital, Bologne, Italy;4. Department of Endocrine and Metabolic Diseases, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy.;1. Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, South Korea;2. Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea;3. Department of Radiology, Research Institute and Hospital, National Cancer Center, Gyeonggi, South Korea;4. Department of Radiology, CHA University College of Medicine, Gangnam CHA Hospital, Seoul, South Korea;5. Department of Radiology, Thyroid Center, Daerim St. Mary''s Hospital, Seoul, South Korea;6. Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.;1. From the Departments of Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio.;2. Clinical Pathology, Cleveland Clinic, Cleveland, Ohio.;3. Endocrinology, Cleveland Clinic, Cleveland, Ohio. |
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| Abstract: | ObjectiveTo describe a case of thyroglossal duct cyst carcinoma that arose in a patient with right thyroid lobe hemiagenesis.MethodsWe present the imaging, physical examination findings, treatment, and clinical course of the study patient.ResultsA 35-year-old woman was evaluated for a neck mass that had been present for 6 months and was slowly growing. She reported a previous diagnosis of right hemithyroid agenesis. The patient’s preoperative workup included ultrasonography of the neck and head and neck T1- and T2-weighted magnetic resonance imaging, which showed right hemithyroid agenesis and a cystic lesion in the median region of the neck below the hyoid bone. Findings from chest x-rays and thyroid function tests were normal. The patient underwent a modified Sistrunk procedure that included removal of the median portion of the hyoid bone. Histologic findings showed a 2.5-cm thyroglossal duct cyst with a 0.6-cm focus of follicular variant of papillary carcinoma with invasion of the cyst wall. Total thyroidectomy was not performed because of the absence of tumoral invasion of the parenchyma around the thyroglossal duct cyst and because the patient was at low risk for aggressive disease. Cervical ultrasonography examinations were performed 6, 12, and 24 months after treatment, and all findings were normal. Presently, the patient is symptom-free after 4 years of follow-up and has no evidence of disease.ConclusionIncidentally discovered, well-differentiated thyroid cancer that is confined to a thyroglossal duct cyst in a patient at low risk for aggressive disease can be adequately treated by a modified Sistrunk procedure that includes the median portion of the hyoid bone. (Endocr Pract. 2008;14:465-469) |
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