Endocrinology & Metabolic Syndrome
Open Access
ISSN: 2161-1017
ISSN: 2161-1017
Mohamed Mansour
South Tees Hospital, NHS Foundation trust, United Kingdom
Scientific Tracks Abstracts: Endocrinol Metab Syndr
Introduction: Thyroglossal duct cysts (TDC) are the most common anomaly occurring during thyroid development. Thyroid carcinoma can be seen in less than 1% of untreated thyroglossal duct cysts. The overall prognosis of primary papillary carcinoma in thyroglossal duct cyst is very good with a five year- survival rate of about 95%. We represent a rare Case of a papillary thyroid carcinoma arising in a thyroglossal duct cyst. Case presentation: A 45-years old patient presented with a central neck swelling. Ultrasound scan of the neck showed a large 2-3cm thyroglossal cyst. Cytological assessment of the aspirate raised the possibility of papillary thyroid carcinoma (PTC). Consequently, the patient had Sistrunk’s operation and PTC of classical type was found. The patient was re-submitted for total thyroidectomy surgery. The final histology of the thyroid gland confirmed multifocal micropapillary thyroid carcinoma with involvement of level VI LNs. Radio-Active Iodine ablation was administrated. No recurrence was detected on 2 years of follow-up. Discussions: PTC in thyroglossal duct cyst is more aggressive in comparison to those arising primarily within the thyroid gland. Pre-operative investigations include US, CT/MRI scans. FNAC has a high false negative rate. Due to the rarity of these cases, controversies exist regarding the best management. Many authors accept that welldifferentiated PTC limited within the walls of the TDC can be managed by Sistrunk’s operation and strict follow-up, while in high-risk categories; male patients, age > 45 years, size >4 cm, extra-cystic invasion, lymph node metastases and/ or the presence of cold nodules in the thyroid gland, Sistrunk’s surgery with total thyroidectomy in addition to post-operative radio iodine ablation with thyroid suppression are indicated. Conclusion: Thyroglossal duct cysts (TDC) needs careful assessment to exclude PTC. MDT discussion is usually recommended.
Mohamed Mansour is a General Surgery Registrar, in James Cool University Hospitals, in UK. He has done his Master’s degree in general surgery, from Cairo University, in Egypt. He has a Membership of the Royal College of Surgeons, MRCS, in England, Uk. He is also having a Fellowship of the American College of Surgeons, FACS, USA.