Dahiya Rockey, Weiss Natalie, May Ryan, Chindris Ana-Maria, Reynolds Jordan P, Janus Jeffrey R, Pirgousis Phillip
Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida, USA.
Division of Endocrinology, Mayo Clinic, Jacksonville, Florida, USA.
Laryngoscope. 2025 Jul 12. doi: 10.1002/lary.32403.
Thyroglossal duct cyst (TGDC) associated carcinoma is rare, accounting for less than 2% of TGDC cases. The majority of cases are classified as papillary thyroid carcinoma (PTC). Standard treatment for TGDC-PTC involves a Sistrunk procedure and prophylactic total thyroidectomy (TT). However, the necessity of these extensive surgical interventions remains debated. This report aims to explore whether individualized surgical approaches may reduce morbidity while maintaining favorable oncological outcomes.
Retrospective case series of three patients with TGDC-PTC.
The age range at presentation for our patients with TGDC-PTC was 26 to 50. Case 1 involved a 38-year-old patient with a cystic mass near the hyoid bone and submental lymphadenopathy who underwent cyst excision with level Ia lymph node clearance. Case 2 is of a 50-year-old patient with a history of TGDC-PTC who presented with a recurrent neck mass 9 years after the initial surgery and underwent a revision Sistrunk procedure. Case 3 presents a 26-year-old patient with a large TGDC and a benign thyroid nodule who underwent a Sistrunk procedure. All three patients had PTC confirmed by final pathology. All had no evidence of recurrent disease at follow-up evaluations ranging from 1 to 12 years.
This case series demonstrates the feasibility and safety of individualized surgical management for TGDC-PTC. Risk stratification allowed for tailored interventions and avoided overly aggressive approaches. Further studies are needed to establish definitive guidelines for managing TGDC-PTC, particularly in low-risk patients.
甲状舌管囊肿（TGDC）相关癌较为罕见，占TGDC病例的比例不到2%。大多数病例被归类为甲状腺乳头状癌（PTC）。TGDC-PTC的标准治疗包括Sistrunk手术和预防性全甲状腺切除术（TT）。然而，这些广泛手术干预的必要性仍存在争议。本报告旨在探讨个体化手术方法是否可以在保持良好肿瘤学结果的同时降低发病率。
对3例TGDC-PTC患者进行回顾性病例系列研究。
我们的TGDC-PTC患者就诊时的年龄范围为26至50岁。病例1为一名38岁患者，舌骨附近有囊性肿块且颏下淋巴结肿大，接受了囊肿切除及Ia区淋巴结清扫术。病例2是一名50岁患者，有TGDC-PTC病史，初次手术后9年出现颈部复发性肿块，接受了改良Sistrunk手术。病例3为一名26岁患者，有一个大的TGDC和一个良性甲状腺结节，接受了Sistrunk手术。所有3例患者最终病理均确诊为PTC。在1至12年的随访评估中，所有患者均无疾病复发迹象。
该病例系列证明了TGDC-PTC个体化手术治疗的可行性和安全性。风险分层允许进行针对性干预，并避免了过度激进的方法。需要进一步研究以建立管理TGDC-PTC的明确指南，特别是针对低风险患者。
