PRIMARY CARCINOMA OF A THYROGLOSSAL DUCT CYST (TGDC) – IS THYROIDECTOMY INDICATED?

Carcinoma of the TGDC is extremely rare (< 1 %). Coexistent thyroid cancer is present in a significant percentage (from 10 % up to 60 %) of these patients. Therefore, one must be sure that the carcinoma arose within the cyst and is not a cystic metastasis to a midline lymph node from a primary thyroid cancer or a pyramidal lobe papillary thyroid cancer. When thyroid ultrasonography shows a normal thyroid gland and in the absence of cervical lymphadenopathy, resection with the Sistrunk procedure is adequate treatment and concomitant thyroidectomy is no necessary. Thyroidectomy should be performed:

I.In the presence of thyroid malignancy or when thyroid malignancy cannot be excluded

II.In the rare cases that have invasive tumor or positive regional lymph nodes (in the anticipation of the need for I-131 treatment and diagnostic whole-body radionuclide imaging

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