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Gazeta Médica

versão impressa ISSN 2183-8135versão On-line ISSN 2184-0628

Gaz Med vol.10 no.3 Queluz set. 2023  Epub 30-Set-2023 

Imagens Médicas

Papillary Carcinoma in a Thyroglossal Duct Cyst

Carcinoma Papilar num Quisto do Canal Tiroglosso

1. Serviço de Radiologia, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.

Keywords: Carcinoma, Papillary/diagnostic imaging; Thyroglossal Cyst/diagnostic imaging

Palavras-chave: Carcinoma Papilar/diagnóstico por imagem; Quisto do Tiroglosso/diagnóstico por imagem

A 24-year-old female presented with an asymptomatic anterior midline neck mass, which developed over the last 6 months. Past medical history was irrelevant. Physical examination revealed a painless, moveable, hard mass.

Cervical ultrasound demonstrated a 4 x 3 cm mainly cystic lesion, consistent with a thyroglossal duct cyst (TGDC), presenting focal solid areas with microcalcifications. Contrast-enhanced computed tomography (CE-CT) showed the lesion located in front of the hyoid bone, with upward extension into oral cavity, and revealed an enhancing mural nodule. These characteristics raised suspicion of malignancy, specifically for papillary carcinoma due to the presence of microcalcifications. A fine needle aspiration biopsy (FNAB) was performed, which revealed cancerous cells, consistent with TGDC papillary carcinoma.

There was no evidence of lymphadenopathy or thyroid nodules. The patient was treated surgically with a Sistrunk procedure, and the diagnosis was confirmed by histopathological examination. At 6-month follow-up, there was no evidence of tumour recurrence.

TGDC is the most frequent congenital midline lesion of the neck.1 It may contain ectopic thyroid tissue with potential to develop malignancy.2 TGDC carcinoma is a very rare lesion (less than 1%), and the most common histologic type is papillary carcinoma (80%-95%).3

They commonly present as an asymptomatic neck mass, and it should be suspected when the lesion is hard or fixed.3,4) They are more frequent in females from third to sixth decade, as seen in our case.1

Cervical ultrasound and CE-CT are fundamental to characterize and adequately stage these lesions. Carcinoma should be considered in TDGC that have a mural nodule or microcalcifications, which correspond to the psammoma bodies seen histologically in papillary carcinomas.5 FNAB is an important tool to evaluate suspicious lesions but has a low sensitivity.4 The diagnosis of TGDC carcinoma can be confirmed in the post-operative histopathological examination.1

The mainstay of treatment is the Sistrunk procedure, which consists of excision of TGDC, the central portion of hyoid bone and a core of tissue around thyroglossal tract to open into the oral cavity at the foramen cecum. Thyroidectomy and neck dissection should be considered, depending on risk stratification and if there is concurred malignancy.1,4

Figure 1: Thyroglossal duct cyst papillary carcinoma. A cervical ultrasound scan shows a cystic lobulated lesion, located anterior to the hyoid bone, with a hyperechoic solid lesion with microcalcifications inside 

Figure 2: Thyroglossal duct cyst papillary carcinoma. Unenhanced (A) and contrast-enhanced CT (B) sagittal scan reveals a cystic mass, anterior to the hyoid bone, with thick septation and an enhancing mural nodule. 


1. Verma R, Patro SK, Damodharan N, Sood A, Bal A. Papillary carcinoma thyroid in a thyroglossal cyst: A management dilemma. Acta Oto-Laryngol Case Rep. 2017;2:5-10. [ Links ]

2. Huang PK, Hsieh LC, Leu YS. Thyroglossal duct cyst papillary carcinoma with airway compromise. Ear Nose Throat J. 2021:1455613211022077. doi: 10.1177/01455613211022077. [ Links ]

3. Pietruszewska W, Wagrowska-Danilewicz M, Józefowicz-Korczyńska M. Papillary carcinoma in thyroglossal duct cyst with uninvolved thyroid. Case report and review of the literature. Arch Med Sci. 2014;10:1061-5. doi: 10.5114/aoms.2014.46226. [ Links ]

4. Kandogan T, Erkan N, Vardar E. Papillary carcinoma arising in a thyroglossal duct cyst with associated microcarcinoma of the thyroid and without cervical lymph node metastasis: A case report. J Med Case Rep. 2008;2:42. doi: 10.1186/1752-1947-2-42. [ Links ]

5. Branstetter BF, Weissman JL, Kennedy TL, Whitaker M. The CT appearance of thyroglossal duct. AJNR Am J Neuroradiol. 2000;21:1547-50. [ Links ]

Declaração de Contribuição/Contributorship Statement

LM: Escrita do artigo

DC e RA: Revisão do artigo

LM: Article writing

DC and RA: Article review

Responsabilidades Éticas

Conflitos de Interesse: Os autores declaram a inexistência de conflitos de interesse na realização do presente trabalho.

Fontes de Financiamento: Não existiram fontes externas de financiamento para a realização deste artigo.

Confidencialidade dos Dados: Os autores declaram ter seguido os protocolos da sua instituição acerca da publicação dos dados de doentes.

Consentimento: Consentimento do doente para publicação obtido.

Proveniência e Revisão por Pares: Não comissionado; revisão externa por pares.

Ethical Disclosures

Conflicts of Interest: The authors have no conflicts of interest to declare.

Financing Support: This work has not received any contribution, grant or scholarship.

Confidentiality of Data: The authors declare that they have followed the protocols of their work center on the publication of data from patients.

Patient Consent: Consent for publication was obtained.

Provenance and Peer Review: Not commissioned; externally peer reviewed.

Received: May 07, 2022; Accepted: June 15, 2023; preprint: July 10, 2023; Published: September 30, 2023

*Autor Correspondente/Corresponding Author: Luís Maduro [] ORCID iD: 0000-0003-1072-075X

Creative Commons License This is an open-access article distributed under the terms of the Creative Commons Attribution License