Puccini Marco, Roffi Nicolò, Pucci Valentina, Fiacchini Giacomo, Ugolini Clara, Buccianti Piero
Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy.
General Surgery Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
SAGE Open Med Case Rep. 2020 May 6;8:2050313X20917846. doi: 10.1177/2050313X20917846. eCollection 2020.
Squamous cell carcinoma and papillary thyroid carcinoma simultaneously spreading from the thyroglossal duct remnant (TGDR) is a very rare event. The recognition of this condition allows a correct management and treatment, offering the best chances of cure to the patient. We describe the case of a 42-year-old woman who noticed a right-sided lump in her neck. An ultrasound scan confirmed multiple clusters of enlarged lymph nodes on the right side associated to a pre-hyoidal solid nodule. The thyroid gland was normal. Fine-needle aspiration cytology on two nodes revealed distinct metastases from squamous cell carcinoma and from papillary thyroid carcinoma. A careful screening for other head and neck tumors was negative. She underwent a Sistrunk procedure, total thyroidectomy and right lateral lymphadenectomy with en bloc jugular vein resection. On histology, a 2 cm papillary and a small squamous cell carcinoma of the TGDR were documented, with nodal metastases from both primaries. We report the overall management strategy, treatment and outcome at 26-month follow-up, and a review of the literature.
鳞状细胞癌和乳头状甲状腺癌同时从甲状舌管残余物（TGDR）扩散是一种非常罕见的情况。认识到这种情况有助于进行正确的管理和治疗，为患者提供最佳的治愈机会。我们描述了一名42岁女性的病例，她注意到颈部右侧有一个肿块。超声扫描证实右侧有多个肿大淋巴结群，与舌骨前实性结节相关。甲状腺正常。对两个淋巴结进行细针穿刺细胞学检查，发现分别来自鳞状细胞癌和乳头状甲状腺癌的转移灶。对其他头颈部肿瘤进行的仔细筛查结果为阴性。她接受了Sistrunk手术、全甲状腺切除术和右侧颈淋巴结清扫术，并整块切除颈静脉。组织学检查显示，TGDR有一个2厘米的乳头状癌和一个小的鳞状细胞癌，两个原发灶均有淋巴结转移。我们报告了26个月随访时的总体管理策略、治疗方法和结果，并对文献进行了综述。
