LaRouere M J, Drake A F, Baker S R, Richter H J, Magielski J E
Department of Otolaryngology, University of Michigan, Taubman Medical Center, Ann Arbor 48109.
Am J Otolaryngol. 1987 Nov-Dec;8(6):351-5. doi: 10.1016/s0196-0709(87)80019-4.
Thyroglossal duct remnants are the most common congenital cystic lesions of the neck; however, a carcinoma arising in these structures is rare. Two new cases of a papillary adenocarcinoma arising in a thyroglossal duct cyst are presented. Preoperative evaluation, operative management, and postoperative care are discussed. Initial evaluation consisting of a thorough head and neck examination, palpation of the thyroid gland, thyroid function tests, and selective use of thyroid imaging is recommended. Removal of the cyst and tract in the manner described by Sistrunk is advocated. If an adenocarcinoma is found in the cyst and if a carcinoma is found in the thyroid gland or a thyroid scan reveals a nodule, a total thyroidectomy is recommended. A modified neck dissection and total thyroidectomy is advocated for cervical metastases. Postoperatively, thyroid suppression and long-term follow-up are encouraged. A squamous cell carcinoma arising in a thyroglossal duct remnant appears more aggressive and requires complete excision and, for confirmed cervical metastases, radical neck dissection and postoperative radiation therapy.
甲状舌管残余是颈部最常见的先天性囊性病变；然而，起源于这些结构的癌很少见。本文报告了2例起源于甲状舌管囊肿的乳头状腺癌新病例。讨论了术前评估、手术处理及术后护理。建议进行初步评估，包括全面的头颈部检查、甲状腺触诊、甲状腺功能检查以及选择性地使用甲状腺成像。主张采用Sistrunk描述的方法切除囊肿及管道。如果在囊肿中发现腺癌，或者在甲状腺中发现癌，或者甲状腺扫描显示有结节，则建议行全甲状腺切除术。对于颈部转移，主张行改良颈清扫术和全甲状腺切除术。术后，鼓励进行甲状腺抑制治疗和长期随访。起源于甲状舌管残余的鳞状细胞癌似乎更具侵袭性，需要完全切除，对于确诊的颈部转移，需行根治性颈清扫术和术后放疗。
