Thyroglossal cyst carcinoma: overview of 15 years experience

 Abstract Background: Thyroglossal duct cysts (TDC) are the most common congenital neck masses arising from the expansion of the epithelial tract remnants occurring during embryogenic thyroid migration. About 7% of the population have thyroglossal duct remnants. Clinical presentation is frequent in children, but adults can also present with thyroglossal duct cysts. Thyroglossal duct cysts may rarely develop carcinomas (1-1.6 %) but tend to occur more in adults than children. Methods: We retrospectively reviewed all cases of TDC carcinoma surgically treated during a 15-years period at Ahwaz Emam Hospital center. Results: Three patients (two female and one male patient), who were 23 to 46 years old (mean 38 yr.) were identified. The frequency of TDC carcinoma among surgically removed TDC cysts was 0.7%. Amidline upper neck mass was the initial symptom in all patients. The diagnosis of cancer was made after the Sistrunk’s procedure in all three cases. All patients had papillary carcinoma. Thyroid involvement was noted in one case. One patient had near-total thyroidectomy, and two received postoperative radioactive iodine. After a mean follow-up of 11 years (range: 1 to 15 yr.), no patient had a documented local recurrence or distant metastatic involvement, and no tumor-associated mortality was observed. Conclusion: Although development of a papillary thyroid carcinoma from thyroglossal cyst is very rare, it should be born in the mind of the surgeon and the pathologist that this possibility exists and the ductal wall should be examined elaborately.