Squamous Cell Carcinoma of a Thyroglossal Duct Cyst and the Role of a Level IA Neck Dissection.

Squamous cell carcinoma of a thyroglossal duct cyst is exceedingly rare, with less than 30 cases reported across the literature. Herein, we present a case of squamous cell carcinoma (SCC) of a thyroglossal duct cyst (TGDC) and discuss the utility of a level IA neck dissection in these cases. In 2018, a 62-year-old female presented to a university-affiliated otolaryngologist with symptoms of dysphagia and a palpable anterior midline neck mass. MRI demonstrated a 3.1 × 2.0-cm mass concerning an invasive TGDC. She was referred to our institution for further management. Preoperative imaging demonstrated an invasive TGDC but no pathological nodes. A Sistrunk procedure and a IA neck dissection were performed. Pathology demonstrated one pathological node in the neck dissection specimen. In summary, a bilateral IA neck dissection was performed on a clinically node zero (N0) patient, and a pathological node was ultimately identified. We hope that by introducing this idea of a IA neck dissection for SCC of a TGDC, we can prompt further investigation into the utility of this procedure for these uniquely rare cases.