Abstract
BackgroundThyroid gland derives from one median anlage at the base of the tongue, and from the two fourth branchial pouches. A number of anomalies may occur during their migration. These can be in form of ectopic tissues, which are frequently found along the course of thyroglossal duct and rarely in other sites, many of these may develop same diseases as the thyroid gland.Case presentationA 36-years-old female presented with a 3 month history of left side neck mass. The mass disappeared following aspiration of brown colored fluid, which on cytological examination showed cells with nuclear irregularities that warranted the resection of the lesion. The histology demonstrated a thyroid papillary carcinoma arising within the branchial cyst. Thereafter, the patient underwent a total thyroidectomy with central lymph nodes dissection. Histology showed a multifocal papillary carcinoma with central lymph nodes metastases. Only four cases of primary thyroid carcinomas in neck branchial cyst have been described so far.ConclusionIn a lateral cystic neck mass, although rare, occurrence of ectopic thyroid tissue and presence of a papillary thyroid carcinoma should be kept in mind.
Highlights
Thyroid gland derives from one median anlage at the base of the tongue, and from the two fourth branchial pouches
A dose of 100 mCi of 131I was administrated in hypothyroidism (TSH 80 mU/ml, thyroglobulin 32 ng/ml, antithyroglobulin antibody negative) and whole body scan showed hyper fixation in mediastinal, median cervical region and diffuse fixation in lungs
Previous reports showed that ectopic thyroid tissue may present metastasis from thyroid carcinoma, and very rarely it may harbour a primary thyroid carcinoma
Summary
Human thyroid gland derives mainly from one median anlage, which develops from invagination in the floor of the primitive pharynx, at the base of the tongue. The ultimobranchial bodies originate from the fifth branchial pouches and migrate downward on each side of the neck From these develop the parafollicular C-cells, which make calcitonin. CiFrirogemugurpleuatr2eadntdotmhoicgkrampahrygisnhsoiwn ilnagtearalol wnedckenrseigtyiolnesion with Computed tomography showing a low density lesion with irregular and thick margins in lateral neck region. The ultrasound (US) evaluation showed a 38.5 mm solitary cystic lesion with irregular margins in the left lateral cervical region that lacked a vascular signal (Figure 1). A computed tomography scan (CT) the neck lesion showed a low density, irregular-circumscribed mass measuring 35 mm (Figure 2). The mass disappeared following a CT-guided aspiration of 15 ml of chocolate brown colored fluid This fluid, on fine needle aspiration cytology (FNAC) examination showed an amorphous and hematic material and cells with nuclear irregularities that warranted the resection of the lesion. A dose of 100 mCi of 131I was administrated in hypothyroidism (TSH 80 mU/ml, thyroglobulin 32 ng/ml, antithyroglobulin antibody negative) and whole body scan showed hyper fixation in mediastinal, median cervical region and diffuse fixation in lungs (pT3 N1b M1)
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