Sikdar Abhik, Nazar Saudah Fazal Ali, Nivsarkar Sameer, Phatak Shrikant, Agarwal Richa, Bhagat Priyanka, Yadav Nitika
Department of ENT, Choithram Hospital and Research Center, Flat 902, Block A3, Avasa Housing, Opp Phalbag, Main AB Road, Indore, Madhya Pradesh 452012 India.
Histopathologist, Choithram Hospital and Research Center, Indore, MP 452014 India.
Indian J Otolaryngol Head Neck Surg. 2025 Jan;77(1):349-355. doi: 10.1007/s12070-024-05186-6. Epub 2024 Nov 5.
Thyroglossal duct cysts are the most common form of congenital neck cysts. The incidence of thyroid papillary carcinoma in thyroglossal duct cyst is less than 1%. In most cases, the diagnosis is made postoperatively. We present a 52-year-old male with sonographically confirmed thyroglossal duct cyst with a large dystrophic calcification in the midline just cranial to the thyroid isthmus, which showed suspicious atypical cells in fine needle aspiration cytology. However, clinically and by contrast enhanced computed tomography neck, it was free from its adjacent tissues with no lymph node involvement. Various treatment modalities were reviewed to formulate a plan of treatment for further management of the patient. Some studies considered near total thyroidectomy as treatment of choice, whereas others categorised the patients into groups according to the risk factors involved and suggested Sistrunk's operation with follow up as the treatment modality in the low-risk group. Present case belonged to low-risk group and so underwent Sistrunk's operation. Histopathology revealed lesion to be encapsulated papillary thyroid carcinoma. The patient has been on regular follow- up for the last 3 months with no radiological or clinical recurrence.
甲状舌管囊肿是先天性颈部囊肿最常见的形式。甲状舌管囊肿中甲状腺乳头状癌的发病率低于1%。在大多数情况下,诊断是在术后做出的。我们报告一名52岁男性,超声检查证实为甲状舌管囊肿,在甲状腺峡部上方中线处有一个大的营养不良性钙化,细针穿刺细胞学检查显示可疑的非典型细胞。然而,临床及颈部增强计算机断层扫描显示,它与相邻组织无粘连,无淋巴结受累。回顾了各种治疗方式,以制定进一步治疗该患者的治疗计划。一些研究认为近全甲状腺切除术是首选治疗方法,而另一些研究则根据所涉及的危险因素将患者分组,并建议低风险组采用Sistrunk手术并进行随访作为治疗方式。本病例属于低风险组,因此接受了Sistrunk手术。组织病理学显示病变为包膜内乳头状甲状腺癌。在过去3个月里,该患者一直在接受定期随访,没有影像学或临床复发。