Simo, Ricard1; Rovira, Aleix1; Alaani, Ausama1; Nixon, Iain1; Jeannon, Jean Pierre1
1 Department of Otorhinolaryngology Head and Neck Surgery, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London, United Kingdom
Introduction: Thyroglossal duct cyst (TDC) is a relatively common diagnosis. However, TDC carcinoma (TDCC) is rare entity. The aim of this study is to. Herein we review the clinical presentation, diagnosis, management strategies and outcomes in a modern cohort of patients with TDCC.
Methods: Retrospective chart review including all patients referred to the Thyroid Oncology Unit at Guy’s and St Thomas’ hospital NHS Foundation Trust between 1998 and 2016 with the diagnosis of TDCC.
Results: Nine patients were included with a mean age at presentation of 43.7 years (31-66 years). Ultrasonography demonstrated TDC in every studied case. CT or MRI was done in cases with multinodular goitre or when suspicious lymph nodes were present. FNAC identified malignancy (Thy 5) in 22,2% of cases, the rest were classified as not diagnostic (55,6%), non-neoplastic (11,1%) or with indeterminate features (11,1%).Apart from Sistrunk procedure performed to all patients, eight patients (88,9%) underwent total thyroidectomy (TT) and central and/or lateral neck dissection (6 after pathological confirmation and 2 in a one-stage procedure). 77,8% of thyroid specimens were positive for papillary thyroid carcinoma and 55,6% of patients had positive lymph nodes. Radio active iodine was administrated to 88,9% of patients. With a mean follow-up of 49,1 months (16-120) all patients were alive with no evidence of recurrence at the end of the studied period.
Conclusions: According to the high incidence of thyroid and lymph node involvement, TT and neck dissections must be strongly considered when dealing with TDCC. Nevertheless, TDCC bears extraordinary survival rates.