Abstract
IntroductionA thyroglossal duct cyst is the most common congenital anomaly of the thyroid gland and midline masses in childhood (70% abnormality in childhood, 7% in adult). Carcinomas arising from a thyroglossal duct cyst are rare (only 1% of thyroglossal duct cyst cases) and characterized by relatively non-aggressive behavior and rare lymphatic spread. They are also diagnosed mostly during the third and fourth decades of life. About 85% to 92% of all thyroglossal duct cyst carcinomas are papillary carcinomas.Case presentationWe present the case of a 44-year-old Iranian woman with Cacausian ethnicity with a painless anterior neck mass that appeared gradually over three months. She had a history of frequent painful swelling of the anterior part of her neck, which subsided with antibiotic therapy. Thyroid functional tests were normal and a thyroid scinitigraphy showed a cold nodule in the left lobe of her thyroid. A computed tomography scan revealed a large, heterogeneous enhancing soft tissue mass with cystic components in the midline of the anterior neck space. This extended from the base of the tongue,(completely separated from its muscles, to the inferior aspect of the thyroid gland and showed the destruction of the hyoid bone and the thyroid cartilage. The diagnosis of a thyroglossal duct cyst with malignant transformation was maintained. A fine needle aspiration revealed papillary carcinoma.ConclusionThis patient's case is presented because of its rare, aggressive, and invasive nature and rare and unusual manifestation, as well as its rapid increase in size, the destruction of the hyoid bone, chondrolysis of the thyroid cartilage, lymph adenopathy and the existence of a cold nodule in the thyroid gland.
Highlights
A thyroglossal duct cyst is the most common congenital anomaly of the thyroid gland and midline masses in childhood (70% abnormality in childhood, 7% in adult)
We present the case of a thyroglossal duct cyst (TDC) papillary carcinoma because of its rarity, unusual manifestation, aggressive nature with invasion to adjacent structures, and interesting history and clinical findings
A computed tomography scan (CT) revealed a relatively large (100 × 55 × 48 mm), heterogeneous enhancing soft tissue mass with a cystic component in the midline of the anterior neck space, that extended from the base of the tongue to the inferior aspect of the thyroid gland and the bilateral aspect of the submandibular gland (Figure 1, Figure 2 and Figure 3)
Summary
This case has been presented because of the rare, aggressive and invasive nature, and rare and unusual manifestation, of the TDC described, as well as the rapid increase in its size, the associated destruction of the hyoid bone, chondrolysis of the thyroid cartilage, lymphadenopathy and the existence of a cold nodule of the thyroid gland. The patient has been disease-free one year after the operation. 7. Sebastian BJ, Sreekumar S, Vaidyanathan S: Thyroglossal duct cyst carcinoma - report of a case and review of literature.
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