Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.
Endocr J. 2013;60(5):665-70. doi: 10.1507/endocrj.ej12-0366. Epub 2013 Jan 12.
Thyroid cancers arising from a thyroglossal duct cyst (TGDC) are rarely reported. No clear consensus exists regarding optimal management. In this light, TGDC carcinomas recently treated at Asan Medical Center, as well as previously reported cases in the literature, were reviewed. There were ten patients who were diagnosed with TGDC carcinoma at our institution. All patients underwent pre-operative fine-needle aspiration biopsy (FNAB). Nine patients were suspected of having papillary carcinoma following cytology. The Sistrunk operation (SO) was performed in four patients, SO with total thyroidectomy (SO/TT) was performed in three patients, and SO/TT with neck dissection was performed in three patients. Six patients who received total thyroidectomy underwent radioactive iodine (RAI) therapy and T4 suppression. With a median follow-up period of 28.5 months, two patients showed recurrence and one of them died of the disease. We analyzed 163 cases from 1990 to 2012 with three or more cases TGDC carcinoma, including the present study. Among 48 patients who underwent FNAB, 75% had papillary thyroid carcinoma (PTC). SO, SO/TT, or SO/TT with neck dissection was performed in 27%, 41%, and 32% of patients, respectively. Among 119 patients who received total thyroidectomy, 36% had concomitant PTC in the thyroid. Among 52 patients who received neck dissection, 69% had cervical nodal involvement. The results of our review suggest that when TGDC carcinoma is suspected, ultrasonography and, if necessary, FNAB should be performed. If these tests reveal a suspected lesion in the thyroid or lymph node, SO/TT and lymph node dissection should be performed.
甲状腺舌管囊肿（TGDC）衍生的甲状腺癌很少见。对于最佳治疗方法，目前尚无明确共识。为此，我们回顾了最近在我院治疗的 TGDC 癌病例，以及文献中之前报道的病例。我院共有 10 例患者被诊断为 TGDC 癌。所有患者均接受了术前细针穿刺活检（FNAB）。9 例细胞学检查怀疑为乳头状癌。4 例行 Sistrunk 手术（SO），3 例行 SO 加甲状腺全切除术（SO/TT），3 例行 SO/TT 加颈部淋巴结清扫术。6 例行甲状腺全切除术的患者接受了放射性碘（RAI）治疗和 T4 抑制治疗。中位随访 28.5 个月，2 例患者复发，其中 1 例死于该病。我们分析了 1990 年至 2012 年 3 例或以上 TGDC 癌的 163 例病例，包括本研究。在接受 FNAB 的 48 例患者中，75%为甲状腺乳头状癌（PTC）。27%、41%和 32%的患者分别行 SO、SO/TT 或 SO/TT 加颈部淋巴结清扫术。在 119 例接受甲状腺全切除术的患者中，36%的患者甲状腺同时存在 PTC。在 52 例接受颈部淋巴结清扫术的患者中，69%的患者有颈部淋巴结转移。本研究结果表明，当怀疑为 TGDC 癌时，应进行超声检查，必要时行 FNAB。如果这些检查显示甲状腺或淋巴结有可疑病变，应行 SO/TT 和淋巴结清扫术。
