Peres Carla, Rombo Nuno, Guia Lopes Leonor, Simões César, Roque Rita
Surgery and Renal Transplantation, Hospital de Santa Cruz - Centro Hospitalar de Lisboa Ocidental, Lisbon, PRT.
Endocrinology, Hospital Egas Moniz - Centro Hospitalar de Lisboa Ocidental, Lisbon, PRT.
Cureus. 2022 Aug 30;14(8):e28570. doi: 10.7759/cureus.28570. eCollection 2022 Aug.
Thyroglossal duct cysts (TGDC) are one of the most common congenital anomalies in the neck. Malignant transformation of these cysts is rare and synchronous involvement of the thyroid gland is even rarer. We report a case of synchronous occurrence of carcinoma in the thyroglossal duct cyst and thyroid gland and review the relevant literature. A 24-year-old woman who presented with a midline cervical mass, clinical examination, and complementary study was suggestive of a thyroglossal cyst with papillary carcinoma on fine-needle aspiration biopsy (FNAB) synchronous with thyroid papillary carcinoma with no cervical ganglion metastases documentation. Sistrunk's procedure plus total thyroidectomy was performed. With the clinical resemblance of benign and malignant cysts and the limitations of imaging techniques to distinguish between them, FNAB might be of use. Surgical treatment is warranted for the treatment of thyroglossal duct cyst carcinoma, but controversy still exists as to the extent of the surgical intervention. Sistrunk's procedure seems to be considered the gold standard when there is no evidence of thyroid involvement. However, in the presence of concomitant thyroid carcinoma, total thyroidectomy and cervical lymphadenectomy for evident node metastases are required. In the case of synchronous thyroglossal and thyroid carcinoma, most authors recommend pursuing both radioiodine therapy and hormone ablation. Thyroglossal duct cyst carcinoma is an uncommon feature that can arise from clusters of thyroid cells found within the cyst as in the present case. When confronted with this diagnosis it is fundamental to take into consideration the possibility of synchronous lesions as well as the extent of local and distance disease, since it has a direct influence on the choice of treatment provided to the patient. As there was a synchronous presence of papillary carcinoma in both the thyroglossal cyst and the thyroid gland, both the Sistrunk procedure and total thyroidectomy were performed, and radioiodine therapy was pursued as well as hormone ablation.
甲状舌管囊肿（TGDC）是颈部最常见的先天性异常之一。这些囊肿的恶性转化很少见，囊肿与甲状腺同时受累则更为罕见。我们报告一例甲状舌管囊肿和甲状腺同时发生癌的病例，并复习相关文献。一名24岁女性，因颈部中线肿块就诊，临床检查及辅助检查提示甲状舌管囊肿，细针穿刺活检（FNAB）显示为乳头状癌，与甲状腺乳头状癌同时存在，无颈部神经节转移记录。行Sistrunk手术加甲状腺全切除术。鉴于良性和恶性囊肿在临床上相似，且影像学技术在区分它们方面存在局限性，FNAB可能有用。手术治疗对于甲状舌管囊肿癌是必要的，但手术干预的范围仍存在争议。当没有甲状腺受累的证据时，Sistrunk手术似乎被认为是金标准。然而，在伴有甲状腺癌的情况下，需要行甲状腺全切除术及对明显的淋巴结转移进行颈部淋巴结清扫术。对于甲状舌管囊肿和甲状腺癌同时存在的情况，大多数作者建议同时进行放射性碘治疗和激素消融。甲状舌管囊肿癌是一种不常见的情况，可如本例所示由囊肿内的甲状腺细胞簇发生。面对这种诊断时，考虑同步病变的可能性以及局部和远处疾病的范围至关重要，因为这直接影响为患者提供的治疗选择。由于甲状舌管囊肿和甲状腺均同时存在乳头状癌，故行Sistrunk手术和甲状腺全切除术，并进行放射性碘治疗及激素消融。
