Papillary Thyroid Carcinoma in a Thyroglossal Duct

  • Thyroglossal duct remnants are commonly seen:
    • Comprising more than:
      • 75% of midline neck tumors in children 
      • 7% in adults
  • Finding a cancer within one of these cysts is rare:
    • One large study reported a prevalence of cancer:
      • In 1.3% of remnants
    • PTC is the most common tumor (90%):
      • Most are less than 1 cm
      • They are typically confined to the cyst
  • Because so few cases have been reported,:
    • No consensus exists about the optimal management
  • Most agree that a Sistrunk procedure is the best way to excise a thyroglossal duct cancer:
    • The necessity for total thyroidectomy is controversial:
      • As only 25% to 56% of patients have concomitant malignancy in the thyroid
    • A retrospective analysis of 18 patients treated at one institution found that:
      • 75% had lateral with or without central lymph node metastases 
      • 56% were found to have tumor foci in the thyroid
      • Twelve patients were given radioiodine
      • With a median follow-up of 12 years (range 1 to 22 years), 11 patients had stimulated thyroglobulin levels available; 10 were undetectable, the other was 2 ng/mL, and all had a negative neck ultrasound
    • Other studies have reported similarly encouraging results with follow-up, regardless of the treatment

#Arrangoiz #ThyroidSurgeon #CancerSurgeon #SurgicalOncologist #HeadandNeckSurgeon #EndocrineSurgery #ThyroidCancer #ThyroglossalDuctCystCancer #PapillaryThyroidCancer #Miami #Mexico #MountSinaiMedicalCenter

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