Li Chao-Fan, Zhang Li-Hong, Li Xue-Shi, Yu Li-Sheng
Department of Otorhinolaryngology-Head and Neck Surgery, Peking University People's Hospital, Peking University, Beijing, China.
Gland Surg. 2023 Apr 28;12(4):555-561. doi: 10.21037/gs-23-102. Epub 2023 Apr 18.
Neoplasia of ectopic thyroid components is relatively rare in thyroglossal duct cysts. We report a case of histopathologically confirmed papillary thyroid carcinoma in a thyroglossal duct cyst, discuss its clinical characteristics of, and provide reference for diagnosis and treatment.
We presented a 25-year-old female went to hospital because of "a tumor in her neck". She was preoperatively diagnosed with thyroglossal duct cyst by cervical ultrasound, and enhanced computed tomography (CT). However, the solid component of the mass suggested intracystic neoplasia. She underwent Sistrunk surgical resection, and postoperative histopathology showed thyroglossal duct cyst, and papillary thyroid carcinoma in the cyst wall. The patient had no high-risk factors and had a low risk of recurrence. After full disclosure, the patient chose close follow-up, and to date there has been no recurrence.
There are controversies regarding the origin of thyroglossal duct cyst carcinoma and the extent of surgery required, and a lack of unified treatment guidelines. We recommend tailoring individualized treatment based on individual risk stratification. By reporting this case, we hope to inform surgeons of the various abnormalities that may occur in ectopic thyroid tissue.
异位甲状腺组织的肿瘤在甲状舌管囊肿中相对少见。我们报告1例经组织病理学确诊的甲状舌管囊肿内甲状腺乳头状癌病例,讨论其临床特征,为诊断和治疗提供参考。
我们报告1例25岁因“颈部肿物”就诊的女性患者。经颈部超声及增强计算机断层扫描(CT)术前诊断为甲状舌管囊肿。然而,肿物的实性成分提示囊内肿瘤形成。患者接受了Sistrunk手术切除,术后组织病理学检查显示为甲状舌管囊肿,囊肿壁内见甲状腺乳头状癌。该患者无高危因素,复发风险低。在充分告知后,患者选择密切随访,迄今为止未出现复发。
关于甲状舌管囊肿癌的起源及所需手术范围存在争议,且缺乏统一的治疗指南。我们建议根据个体风险分层制定个体化治疗方案。通过报告该病例,我们希望告知外科医生异位甲状腺组织可能出现的各种异常情况。