Thyroglossal duct cyst is one of the most common benign tumors located in the cervical region, with most studies estimating its incidence in the general population at 5–7%. Of all patients undergoing excision of a thyroglossal duct cyst, fewer than 1% show malignant cellular changes, which are generally discovered incidentally on histopathological examination.
Case presentation: A 14-year-old female patient was referred to the emergency department from a private hospital for an anterior cervical mass that had first appeared 4 months earlier and had increased in size over the previous month and a half. The patient also presented with dysphonia, dysphagia, and marked nocturnal stertor. At the private hospital where she initially presented, she had been diagnosed with a thyroglossal duct cyst and surgery was planned. During the attempt to insert the ETT, the anesthesiologist observed a large laryngeal deformity and decided to stop the procedure. At our center, the patient underwent ultrasound, flexible nasopharyngolaryngoscopy (which revealed a large mass in the right hemilarynx), contrast-enhanced cervical CT, and cervical MRI. Despite all these investigations, it was not possible to establish with certainty the origin of the tumor (cervical or laryngeal), and an exploratory cervicotomy with excision of the lesion was therefore performed. The preliminary pathological result established the diagnosis of a thyroglossal duct cyst, but a more detailed evaluation revealed malignant changes in one region of the specimen.
This case represents a diagnostic first for our center and required a collective effort from everyone involved: ENT surgeons, radiologists, and pathologists.
References
Houas J, Ghammam M, Laabidi E, Khalfi O, Bellakhdher M, Abdelkefi M. Malignant degeneration of thyroglossal duct cysts: Clinical aspects, imaging findings and management: Case series. Int J Surg Case Rep. 2024 Feb;115:109325. doi: 10.1016/j.ijscr.2024.109325. Epub 2024 Feb 1. PMID: 38301307; PMCID: PMC10847149.