Skalias Antonios, Garefis Konstantinos, Tsetsos Nikolaos, Goudakos John
Department of Otorhinolaryngology, Head and Neck Surgery, 424 General Military Training Hospital, Thessaloniki, Greece.
2nd Academic ORL, Head and Neck Surgery Department Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece.
Maedica (Bucur). 2024 Sep;19(3):648-651. doi: 10.26574/maedica.2024.19.3.648.
Lateral cervical cystic masses are a relatively common occurrence in the otolaryngology practice, which are often attributed to second branchial cleft cysts. However, there should always be a high suspicion for malignancy until proven otherwise.
We present a clinical report of a lateral cervical cyst surgical excision where histopathological examination has revealed features of a branchial cleft cyst harboring a papillary thyroid carcinoma. This led to the clinically latent thyroid primary which was treated through thyroidectomy with selective neck dissection and radioactive iodine therapy.
Across current literature regarding thyroid carcinomas arising within branchial cysts, primary thyroid carcinoma was identified in almost half the cases where thyroidectomy was performed. There is no established consensus on the decision of whether to perform a thyroidectomy in such cases, due to the paucity of data for similar cases.
Although branchial cyst is a benign condition, it can harbor malignancy. When thyroid carcinoma occurs within such a cyst, without solid evidence of a thyroid primary, treating physicians are presented with a diagnostic and treatment dilemma. As more cases are discovered and reported, navigating this challenging dilemma will become clearer for the treating physicians.
颈部外侧囊性肿物在耳鼻喉科临床实践中较为常见，通常被认为是第二鳃裂囊肿。然而，在未排除恶性之前应始终高度怀疑。
我们呈现一例颈部外侧囊肿手术切除的临床报告，组织病理学检查显示为含有乳头状甲状腺癌的鳃裂囊肿。这发现了临床上隐匿的甲状腺原发灶，通过甲状腺切除术加选择性颈部清扫和放射性碘治疗。
在目前关于鳃裂囊肿内发生甲状腺癌的文献中，几乎一半行甲状腺切除术的病例发现了原发性甲状腺癌。由于类似病例的数据匮乏，对于此类病例是否进行甲状腺切除术尚无定论。
尽管鳃裂囊肿是良性疾病，但可能隐匿恶性病变。当甲状腺癌发生在这样的囊肿内，且没有甲状腺原发灶的确切证据时，治疗医生会面临诊断和治疗困境。随着更多病例被发现和报告，治疗医生应对这一具有挑战性的困境将变得更加清晰。
