Obstructive sleep apnoea in a case of thyroglossal duct cyst carcinoma.

OBJECTIVES To report a rare case of thyroglossal duct cyst carcinoma which presented with obstructive sleep apnoea, and to highlight the difficulties in making this clinical diagnosis. METHOD Case report and review of the English language literature concerning thyroglossal duct cyst carcinoma. RESULTS Thyroglossal duct cyst carcinoma is a rare clinical entity found in only approximately 1 per cent of all patients operated upon for thyroglossal duct cyst. This condition usually presents in an identical manner to its benign counterpart; atypical presentations have not previously been reported. Our patient is the first reported case of a thyroglossal duct cyst carcinoma first presenting with symptoms of obstructive sleep apnoea, without a neck mass. Complete surgical excision with total thyroidectomy and lymph node clearance was performed, in view of the positive lymph node metastases (seen on imaging) and the need for post-operative radioiodine therapy. CONCLUSION Thyroglossal duct cyst carcinomas may present atypically, posing a diagnostic dilemma for the clinician. For patients diagnosed with obstructive sleep apnoea, it is imperative that a thorough otolaryngological examination be performed to exclude any underlying pathology.