Diagnosis and treatment of thyroglossal duct carcinoma: report of three cases with review of literatures

Abstract  Thyroglossal duct carcinoma, which is usually diagnosed postoperatively, is a rare malignant tumor arising in the thyroglossal
duct cyst. The definitive diagnosis can be made only after microscopic examination. We retrospectively reviewed three cases
of thyroglossal duct carcinoma diagnosed in Peking University School and Hospital of Stomatology from January 1986 to August
2006. Clinical and pathological features were investigated and the optimal treatment protocol was proposed. The constituent
ratio of thyroglossal duct carcinoma among surgically excised thyroglossal duct lesions was 2.9%. The clinical presentation
of thyroglossal duct carcinoma was very similar to that of its benign counterpart. Two cases were diagnosed as thyroglossal
duct cyst prior to the operation, the remaining one as dermoid cyst. All three cases were diagnosed as papillary carcinoma
of thyroid origin after microscopic examination. Primary thyroglossal duct carcinoma should conform to the following criteria:
localization of the carcinoma to a clearly demonstrable thyroglossal duct cyst or tract; clinically or histologically confirmed
absence of carcinoma of the thyroid gland. Papillary carcinoma is the most common histological type, which usually develops
slowly with an excellent prognosis. The histological characteristics including: formation of papillary structure; nuclear
morphological variations such as ground glass nuclei, pseudoinclusions, intranuclear grooves and filaments; concentrically
calcified structures termed psammoma bodies which is regarded as a strong indication of papillary carcinoma; and positivity
in immunohistological staining for thyroglobin. Sistrunk procedure of excision is the choice for treatment. A close follow-up
is needed. In the presence of thyroid gland masses or cervical lymphadenopathy, thyroidectomy or neck dissection should be
recommended. The effect of thyroid suppression therapy and radioactive iodine therapy is not conclusive.

Content Type Journal ArticleCategory Research ArticleDOI 10.1007/s11684-008-0011-4Authors
Zhipeng Sun, Peking University School and Hospital of Stomatology Department of Oral and Maxillofacial Surgery Beijing 100081 ChinaChuanbin Guo, Peking University School and Hospital of Stomatology Department of Oral and Maxillofacial Surgery Beijing 100081 ChinaGuangyan Yu, Peking University School and Hospital of Stomatology Department of Oral and Maxillofacial Surgery Beijing 100081 ChinaYi Zhan, Peking University School and Hospital of Stomatology Department of Oral and Maxillofacial Surgery Beijing 100081 ChinaYan Chen, Peking University School and Hospital of Stomatology Department of Oral Pathology Beijing 100081 ChinaYan Gao, Peking University School and Hospital of Stomatology Department of Oral Pathology Beijing 100081 China

Journal Frontiers of Medicine in ChinaOnline ISSN 1673-7458Print ISSN 1673-7342

Journal Volume Volume 2

Journal Issue Volume 2, Number 1 / March, 2008 (Source: Frontiers of Medicine in China)