The incidence of thyroid papillary carcinoma in thyroglossal duct cyst is <1%. Regional lymph node metastasis is usually seen in cases who have intrathyroidal tumor. We report a case of thyroid papillary carcinoma arising from thyroglossal duct cyst with lateral lymph node metastasis who have a normal thyroid gland and benign central compartment lymph nodes.
Case report: A 38-year-old male patient was admitted with the complaint of swelling in the neck. It was a cystic lesion (thyroglossal duct cyst?) and 16×32 mm in size on ultrasonography. The thyroid gland ultrasound was normal. There was a lesion on the left neck extending up from the upper to the lower jugular chain, measured 55×25 mm in size, containing millimetric calcifications which was suspected to be metastasis of papillary thyroid carcinoma. The fine needle aspiration cytology of this lesion was positive for metastases of papillary carcinoma of the thyroid. Thus, thyroglossal duct cyst excision and bilateral total thyroidectomy with central and left neck dissection was performed.
Thyroglossal duct cyst specimen pathology has been reported as an invasion of the bone and soft tissue in the form of papillary thyroid carcinoma. All of the central lymph nodes were reactive and thyroid gland was normal but there was a metastatic lymph node in the lateral neck dissection which is 7 cm in diameter.
Conclusion: This is a rare case due to have a thyroid papillary carcinoma arising from thyroglossal duct cyst with lateral lymph node metastasis and without a tumor in thyroid gland and without central lymph node metastasis. As a result, while evaluating a thyroglossal duct cyst, in all cases, a detailed neck ultrasonography should be performed and biopsy should be done from suspected lymph nodes before planning the surgery.
27 Apr - 01 May 2013
European Society of Endocrinology