Surgical Management of Primary Thyroid Carcinoma Arising in Thyroglossal Duct Cyst
R. Dzodic1, I. Markovic1, B. Stanojevic3, V. Saenko2, M. Buta1, I. Djurisic1, M. Oruci1, Z. Milovanovic1 & S. Yamashita2
Background: Thyroid carcinoma in a thyroglossal duct cyst is very rare and surgical management is based on the individual experience.
Patients and methods: Twelve cases of primary TDC thyroid carcinoma operated in one Institution during last 25 years. Sistrunk`s procedure was done in all cases followed by dissection of submental and prehyoid lymph nodes and bilateral biopsy of level 3. In the same act 11 of 12 patients underwent total thyroidectomy. In cases of synchronous thyroid gland carcinomas central neck dissection and frozen-section examination of level IV LN was done. In cases of LN involvement modified radical neck dissections (MRND) were performed.
Results: Definitive pathology revealed 11 papillary and one follicular TC in TDC. Synchronous thyroid gland carcinoma was found in 3 cases (27%). LN metastases were found in six patients (50%) MRND was done in 5 cases and central neck dissection in four cases. Radioiodine therapy was applied in five patients. All our patients are alive.
Conclusion: TDC carcinoma is essentially a thyroid carcinoma and must be treated as a primary thyroid cancer. Our results imply that TC in TDC were associated with synchronous thyroid gland carcinomas in one-third and LN metastases in half of cases Active searching for cervical metastases is highly recommended considering the high incidence of LNM in papillary thyroid carcinoma. In a lack of surgical consensus, this algorithm can be safely applied to obtain optimal radical surgery in those patients.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector