Papillary carcinoma arising from a thyroglossal duct cyst: A case report and literature review

INTRODUCTION: Papillary carcinoma originating from a thyroglossal cyst is rare and peculiar, with majority of cases detected after surgery. Despite an excellent prognosis, its management remains controversial. Herein, we report the case of a 53-year-old woman who underwent Sistrunk procedure for a thyroglossal duct cyst and was subsequently confirmed to have papillary thyroid carcinoma. PRESENTATION OF CASE: A 53-year-old woman presented with an anterior midline neck mass for 7 years. The patient had no symptoms of hypo-or hyperthyroidism. Additionally, she had no history of compressive symptoms. Neck ultrasound revealed a well-defined 3.5 cm × 2.2 cm × 3 cm-sized cystic lesion inferior to the hyoid bone, with a peripheral solid component. Neck computed tomography revealed a well-defined 3.7 cm × 3.4 cm × 2.7 cm-sized cystic lesion with an enhanced central solid component with focal calcifications, inferior to the hyoid bone, and in contact with the anterior wall of the thyroid cartilage. Sistrunk procedure was performed. The patient was then diagnosed with papillary thyroid carcinoma with TNM stage pT2 and underwent total thyroidectomy as a follow-up procedure. DISCUSSION: Thyroglossal duct cyst carcinoma is usually detected in the fourth decade of life with a higher prevalence in women. Neck ultrasound is performed during the initial radiological workup to assess the cyst and confirm the presence of the thyroid gland. CONCLUSION: The Sistrunk procedure is highly effective in low-risk patients. A more aggressive approach is required for high-risk patients.