Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
Sign up to receive an email alert when a new Case of the Week is posted.
February 23, 2017
Thyroglossal Duct Cyst Papillary Carcinoma
- Background:
- Malignant neoplasias are a rare complication of thyroglossal duct cysts, occurring in ~1% of cases. 95% of thyroglossal duct cyst malignancies are papillary carcinomas, and the remaining 5% are squamous cell carcinomas.
- There are approximately 260 cases of thyroglossal duct cyst papillary carcinoma reported in the literature.
- Clinical Presentation:
- Most cases in the literature were identified after histologic examination of what was thought to be an uncomplicated thyroglossal duct cyst. This helps to explain the lack of information about imaging appearance of thyroglossal duct cyst neoplasias.
- Rapid cyst enlargement, fever and weight loss, and the presence of a solid lesion within the cyst should alert the clinician to a possible malignancy.
- Key Diagnostic Features:
- Presence of solid components such as mural nodules, irregular wall thickening, or thick septa within a thyroglossal duct cyst; microcalcifications on ultrasound are almost pathognomonic
- Presence of regional lymphadenopathy
- Differential Diagnoses:
- Other complications of the thyroglossal duct cyst like hemorrhage and infection
- Some findings that can help identify these complications are heterogeneous cyst content, smooth wall thickening, debris, and inflammatory changes in the surrounding tissues.
- Treatment:
- Since it is a rare complication, there is not enough information to suggest specific treatment.
- Most patients in case reports were treated according to guidelines for thyroid papillary carcinoma, including cyst resection, lymphadenectomy, total thyroidectomy, and radioactive iodine treatment, with favorable outcomes.
Current Issue
Case Collections
