PAPILLARY CARCINOMA IN THYROGLOSSAL DUCT CYST WITH NODAL METASTASIS IN THE PRESENCE OF A NORMAL THYROID GLAND

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 459-496-Thyroid Neoplasia & Case Reports
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-461
Muhammad Qamar Masood*1 and Ali Asghar2
1The Aga Khan University, Karachi, Pakistan, 2Aga Khan University Hospital, Karachi, Pakistan
BACKGROUND: Thyroglossal duct cyst is the most common congenital anomaly of the neck. Occurrence of papillary thyroid carcinoma in thyroglossal duct cyst with nodal metastasis in the presence of a normal in situ thyroid gland is rare.

CLINICAL CASE: We present the case of a 44 year old male, who presented with anterior midline neck swelling. The swelling was present since birth, but had been gradually increasing in size recently. CT scan of neck showed a 7.0 x 5.0 x 4.5 cm multi-loculated well defined cystic mass, incorporating an enhancing area within it measuring 1.9 x 1.7 cm showing calcification. Fine needle aspiration revealed a benign cystic lesion. Therefore a sistrunk’s procedure was performed. Histopathology showed papillary carcinoma of thyroid. Subsequent ultrasound examination of neck revealed few lymph nodes in left cervical chain but a normal thyroid gland. Nodal metastasis was suspected with thyroid gland thought as the likely primary site of origin for the cancer. Total thyroidectomy with bilateral neck dissection was done. Histopathology showed benign thyroid tissue with lymph node metastasis. Patient subsequently received radioactive iodine ablation and long term TSH suppressive therapy. There is no recurrence of disease after 18 months of follow up.

CONCLUSION: This case depicts a rare presentation of papillary carcinoma in thyroglossal duct cyst with nodal metastasis but a normal in situ thyroid gland. This case highlights the fact that malignancy should always be considered while dealing with thyroglossal duct cysts, and nodal metastasis may be present with a normal thyroid gland.

Nothing to Disclose: MQM, AA

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