Cases reported "Thyroglossal Cyst"

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1/164. Papillary carcinoma in a thyroglossal duct: case report.

    CONTEXT: Thyroglossal duct cysts are the most common congenital cervical abnormality in childhood. Malignant lesions are rare in thyroglossal duct cysts (about 1%). OBJECTIVE: To report a case of papillary carcinoma in thyroglossal duct cysts. DESIGN: Case report. CASE REPORT: The patient was a 21-year-old female with a four-month history of an anterior midline neck mass but without other symptoms. The physical examination revealed a 4.0 cm diameter, smooth, painless, cystic nodule at the level of the hyoid bone. The thyroid gland was normal by palpation and no neck lymph nodes were found. Indirect laryngoscopy, fine-needle biopsy aspiration and cervical ultrasound were normal and compatible with the physical findings of a thyroglossal duct cyst. The patient underwent surgery with this diagnosis, under general anesthesia, and the mass was resected by the usual Sistrunk procedure. There were no local signs of invasion of the tissue surrounding the cyst or duct at surgery. The patient was discharged within 24 hours. Histopathological examination of the specimen showed a 3.5 x 3.0 x 3.0 cm thyroglossal cyst, partially filled by a solid 1.0 x 0.5 cm brownish tissue. Histological sections showed a papillary carcinoma in the thyroid tissue of a thyroglossal cyst, with normal thyroid tissue at the boundary of the carcinoma. There was no capsule invasion and the margins were negative. The follow-up of the patient consisted of head and neck examinations, ultrasonography of the surgical region and thyroid, and total body scintigraphy. The patient has been followed up for two years with no further evidence of disease.
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2/164. diagnosis of papillary carcinoma in a thyroglossal duct cyst by fine-needle aspiration biopsy.

    The incidence of papillary thyroid carcinoma arising in a thyroglossal duct cyst is rare and occurs in about 1 % of thyroglossal duct cysts. Only 17 such cases diagnosed with fine-needle aspiration biopsy have been previously reported in the English-language literature, with a diagnostic rate of 53%. In this article, the cytologic features of the current case are emphasized and those of the previous reported cases are briefly reviewed. Diagnostic pitfalls of papillary carcinoma arising in thyroglossal duct cysts diagnosed by fine-needle aspiration biopsy are also discussed.
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3/164. Intrathyroid thyroglossal duct cyst simulating a thyroid nodule.

    A case of intrathyroid thyroglossal duct cyst is reported. A 50-year-old woman presented with a right lateral neck mass that was clinically indistinguishable from a thyroid nodule. Ultrasound-guided fine-needle aspiration biopsy (US-FNAB) revealed normal-looking squamous cells. Right thyroid lobectomy was performed and microscopic examination revealed a cyst lined by squamous epithelium that was consistent with a thyroglossal duct cyst. The lesion was completely surrounded by normal thyroid tissue. Our experience suggests that intrathyroid thyroglossal duct cyst should be remembered in the differential diagnosis of a thyroid nodule. Detection of benign squamous cells by US-FNAB may be useful for ruling out the possibility of a cystic thyroid tumor.
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4/164. Breath-holding-like spells in an infant: an unusual presentation of lingual thyroglossal duct cyst.

    The authors report the case of an infant with a lingual thyroglossal duct cyst who presented with breath-holding-like spells, which actually represented life-threatening ball-valve obstruction of the larynx, leading to hypoxemia and transient cerebral dysfunction. When evaluating apparent breath-holding spells in young infants, physicians should include dynamic, episodic upper airway obstruction in the differential diagnosis.
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5/164. Thyroglossal duct carcinoma.

    Primary carcinoma of the thyroglossal duct is rare. This discussion reports two cases and reviews the 50 previously reported in the literature. The criteria for diagnosis include evidence of a thyroglossal duct remnant and a normal thyroid gland. The differentiation from cystic metastases to lymph nodes is pointed out. The histologic types parallel those of carcinoma of the thyroid gland, papillary carcinoma being the most common and having a generally favorable prognosis. The clinical presentation of these tumors is similar to that with benign cysts and thus is of limited value in the diagnosis.
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6/164. Papillary carcinoma in thyroglossal duct remnants: presentation of four cases and decision procedure for prophylactic thyroid gland dissection.

    Papillary carcinoma in thyroglossal duct remnants is a rare and usually unexpected finding. It is controversial whether or not prophylactic thyroid gland dissection is necessary in such circumstances. We present our experience of four cases. Based on this, a consideration of published risk factors, and evaluation of the likelihood of a primary versus metastatic origin of the malignancy, we present a therapeutic decision procedure. When the thyroid is normal, the patient presents low-risk factors for thyroid cancer, and there is evidence that the malignancy is primary, removal of all thyroglossal duct remnants by the Sistrunk procedure is sufficient.
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7/164. Papillary adenocarcinoma of the thyroid in a thyroglossal duct cyst.

    A case report is presented of an 8-year-old boy who underwent resection of a thyroglossal duct cyst to illustrate a rare, but significant, complication of a common clinical problem. Pathological examination revealed that it contained a papillary adenocarcinoma of the thyroid, presumably arising from ectopic glandular tissue in the cyst. Thyroglossal duct cysts are a common cause of midline neck masses in children. Occult thyroid carcinoma is a rare co-morbid finding. It infrequently leads to death, but thyroglossal duct cysts may also contain the only functioning, albeit ectopic, thyroid tissue. patients with clinical thyroglossal duct cysts should be carefully evaluated preoperatively for the presence of tumor and other functioning thyroid tissue prior to excision of the cyst.
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8/164. Papillary carcinoma in a giant thyroglossal duct cyst.

    Thyroglossal duct cysts (TGDCs) are common, however, a malignancy occurring in a TGDC is rare. The presence on an underlying malignancy is clinically occult but may be detected on preoperative imaging studies. We describe the CT findings of a papillary carcinoma occurring in a TGDC.
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9/164. A thyroglossal duct cyst with calcification.

    We report a thyroglossal duct cyst with calcification, the second case in the world literature. The ultrasound and CT findings are described and we highlight the differential diagnosis.
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10/164. Papillary thyroid carcinoma in thyroglossal duct cyst.

    Thyroglossal duct remnants are the most common midline neck swellings, but carcinoma is found in approximately 1% of these lesions. The cysts are usually asymptomatic and the presentation of the patient with carcinoma is indistinguishable from the common cyst. Papillary adenocarcinoma comprises 75-85% of the tumors reported. A 36-year-old woman underwent Sistrunk procedure for excision of a thyroglossal cyst. No thyroid abnormality was noted pre-operatively nor during the surgical examination. The histopathological examination revealed papillary carcinoma. She has been maintained on thyroxine suppression and was doing well at 14 months' follow-up. Carcinoma of the thyroglossal duct cyst is rare. The ultrasonographic examination should be performed pre-operatively for thyroid gland study. The main question is what to do with the thyroid gland. There still is controversy about thyroid removal for a papillary carcinoma, but all the patients should receive suppressive doses of thyroid hormone. As the cure rate is 95% for the patients whose thyroid is preserved and further postoperative complications are avoided, we can consider that the optimal surgical procedure for thyroglossal duct carcinoma is the same as that for the benign cyst.
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