A Rare Case Report of Thyroglossal Duct Cyst Carcinoma Coexisting with Thyroid Carcinoma in an Adolescent.

Autor: Mylopotamitaki K; Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion 'Venizeleio-Pananeio', Heraklion, Crete, Greece.; University of Crete, School of Medicine, Greece., Klonaris D; Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion 'Venizeleio-Pananeio', Heraklion, Crete, Greece., Kazamias G; Department of Pathology, General Hospital of Heraklion 'Venizeleio-Pananeio', Heraklion, Crete, Greece., Simandirakis C; Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion 'Venizeleio-Pananeio', Heraklion, Crete, Greece., Vourliotaki I; Department of Endocrinology, General Hospital of Heraklion 'Venizeleio-Pananeio', Heraklion, Crete, Greece., Karakostas E; Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Heraklion 'Venizeleio-Pananeio', Heraklion, Crete, Greece.
Jazyk: angličtina
Zdroj: Case reports in otolaryngology [Case Rep Otolaryngol] 2023 Sep 05; Vol. 2023, pp. 6640087. Date of Electronic Publication: 2023 Sep 05 (Print Publication: 2023).
DOI: 10.1155/2023/6640087
Abstrakt: Background: Thyroglossal duct cysts (TDC) represent approximately 70% of all congenital neck masses, and up to 1% of them contain thyroid tissue malignancies. Clinical presentation of TDC carcinomas is usually indistinguishable from benign tumors preoperatively, and differential diagnosis can be challenging. We present a rare case of TDC carcinoma concurrent with thyroid cancer in an adolescent. Case Presentation . A 16-year-old Caucasian female, otherwise healthy, was referred with a painless, gradually expanding lump on the neck. Physical examination revealed a well-circumscribed, moderately hard, tender mass of the anterior neck midline anteroinferior to the hyoid bone. Imaging findings suggested TDC as the most likely diagnosis. The patient had a Sistrunk procedure under general anesthesia. Histopathological findings diagnosed a BRAF V600E -positive papillary thyroid carcinoma (PTC) in a TDC. A thyroid gland and neck ultrasound revealed a highly suspicious finding for malignancy right level VI lymph node, which was not confirmed by fine needle aspiration cytology (FNAC). Under general anesthesia, total thyroidectomy and central compartment lymph node neck dissection were performed. Histopathological findings revealed a thyroid parenchymal locus of PTC, as well as three lymph nodes infiltrated by PTC. The patient received adjuvant radioactive iodine ablation (RAI) therapy and is closely followed.
Conclusion: TDC carcinomas in conjunction with thyroid carcinomas in young patients are rare. Preoperative diagnosis can be challenging, as the vast majority of neck masses in young patients are benign in nature, and most malignant tumors lack specific clinical features. The diagnostic accuracy of FNAC is considered unsatisfactory due to its frequently cystic nature. Definitive diagnosis is based on histopathological findings. Clinicians should maintain a high level of suspicion for coexisting thyroid malignancies. Although surgical extirpation of the malignancy is considered standard of care, the treatment of TDC cancer should always be individualized by a multidisciplinary team.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2023 Kleanthi Mylopotamitaki et al.)
Databáze: MEDLINE
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