Papillary thyroid carcinoma in a thyroglossal duct cyst: A case report of a 40-year-old female patient at Hawassa University Comprehensive Specialized Hospital

Abstract

Thyroglossal duct cyst (TDC) is a common congenital anomaly of the thyroid gland, usually presenting as a midline neck mass. The presence of malignancy occurring within these cysts is a rare condition, accounting only for 1% of all cases of thyroglossal duct cyst. Usually, the diagnosis is only made postoperatively after excision of the cyst. Given the rarity of thyroglossal duct cyst carcinoma, definitive treatment is not well agreed upon. The Sistrunk’s procedure can be the sole procedure or it can be followed by total thyroidectomy,nodal dissection, and postoperative radioactive iodine treatment. Here, we present a case of papillary carcinoma of the thyroglossal duct cyst in a 40-year-old female patient who presented with a painless anterior neck swelling above the thyroid cartilage. She had an ultrasound guided FNAC of the mass which suggested papillary thyroid carcinoma. She then underwent a Sistrunk’s procedure and has had an uneventful post-operative course. Postoperative histopathology showed papillary thyroid carcinoma with surrounding fibro fatty tissue remnant. Interestingly, no normal thyroid tissue was noted in the specimen. Papillary carcinoma of TDC, which is the most common carcinoma of TDC, should only be treated with the Sistrunk’s procedure and strict long-term follow up, in the absence of high-risk features. The purpose of this case report is to increase the awareness among physicians on how to approach this rare disease, including its work up and entertain the various management options in addition to the Sistrunk’s procedure.