2020 Volume 63 Issue 6 Pages 287-293
We report a case of papillary carcinoma in a multilocular thyroglossal duct cyst associated with papillary carcinoma in the right lobe of the thyroid. A 72-year-old woman presented to our otorhinolaryngology clinic with a 1-year history of swelling of the anterior neck. Physical examination showed an elastic-hard tumor measuring about 40 mm in size. Imaging examination revealed a multilocular thyroglossal duct cyst extending from the midline of the neck to the thyroid cartilage and a calcified mass in the right lobe of the thyroid. A solid lesion with calcification was also observed in the thyroglossal duct cyst. The findings of fine-needle aspiration biopsy of the thyroid lesion were categorized as class V and those of the lesion in the thyroglossal duct cyst as class I. Surgery was performed under general anesthesia for resection of the papillary thyroid carcinoma and of the thyroglossal duct cyst. Histopathological examination revealed that besides the papillary cancer in the right lobe of the thyroid, the lesion arising from the thyroglossal duct was also a papillary carcinoma. We made the diagnosis of papillary carcinoma in a multilocular thyroglossal duct cyst and papillary thyroid carcinoma of the right lobe of the thyroid. Postoperative examinations revealed no lymph node metastasis or distant metastasis. As the malignant lesion in the thyroglossal duct was limited to one of the cysts, we followed the patient up without any additional treatment. Until the last follow-up, 8 months after the surgery, she had shown no signs of recurrence. In this patient, papillary carcinoma was found in a solid lesion within a cyst of the thyroglossal duct. If we had diagnosed papillary carcinoma of the thyroid with thyroglossal duct carcinoma preoperatively, we may have chosen total thyroidectomy and radioiodine thyroid ablation as treatment. For preoperative diagnosis of thyroglossal duct carcinoma, it is important to reliably harvest tissue from a site of calcification or solid lesion in the thyroglossal duct cyst.
