Incidental Discovery of a Papillary Thyroid Carcinoma in a Thyroglossal Duct Cyst: Clinical Case

The thyroid gland descends embryologically from the foramen to its anatomical location below the thyroid cartilage. It leaves behind an epithelial tract known as the thyroglossal tract; this tract usually disappears during the 5th to 10th week of gestation. Our patient is 52 years old, without notable history, who presented a slightly left-lateralized median cervical swelling of 5 cm with a long axis, fixed in superficial plane and mobile in deep plane. TTCs are the most common congenital anomalies in thyroid development, but carcinomas on TTC are extremely rare, with 90% of them arising from thyroid remnants. Papillary types represent 94% and less than 5% are of squamous origin. Their cause is unknown and there are no predisposing factors, neither clinical history nor physical examination can lead to a preoperative diagnosis. Surgery remains the main line of treatment, performing the Sistrunk procedure with or without total thyroidectomy in addition to excision of the cervical lymph nodes in some cases. In low-risk patients, Sistrunk operation might be sufficient, while in high-risk patients, a combined modality approach should be adopted.