PMC7393466_01
Patient with midline neck swelling.
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Physical examination showed a well-demarcated, mobile, midline cervical swelling of about 4 cm in diameter (Fig. 1) that moved with swallowing and with tongue protrusion.
Ultrasound of the neck showing A. Midline neck swelling (TGDC); B & C. Right thyroid lobe nodule (TI-RADS 4).
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Ultrasound scan of the neck (Fig. 2) showed a midline heterogenous solid and cystic mass (3.6 x 2.3 cm) with thickened internal echoes and calcification, extending to the right side of the neck.
A. Sistrunk's procedure: removal of the thyroid gland (arrow 3) and thyroglossal duct cyst (arrow 2) with the anterior portion of the hyoid bone (arrow 1); B. After complete excision of thyroid gland and thyroglossal duct cyst.
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TGDC using the Sistrunk procedure (Fig. 3). The surgical procedures were undertaken by an experienced thyroid surgeon and were uneventful.
Specimen (thyroid gland and thyroglossal duct cyst en block) after fixation in formalin.
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A. Thyroglossal duct cyst showing characteristic features of papillary carcinoma (H&E x 2); B. Papillary carcinoma expanding the right thyroid nodule (H&E x 2).
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Whilst the carcinoma in the TGDC displayed a predominantly papillary morphology (Fig. 5A), the carcinoma in the right thyroid nodule showed a mixture of papillary and follicular patterns (Fig. 5B).