Papillary Thyroid Carcinoma in a Thyroglossal Cyst in an Adult Patient

A Thyroglossal cyst is amongst the most commonly encountered anterior painless neck swelling. Its usual presentation is seen in childhood and rarely presents in adulthood. The management for Thyroglossal cyst is, the Sistrunk’s Operation. The etiology is explained by embryonic development of the Thyroglossal duct and its deficiency to obliterate after birth. Here we present a case of a 45 year old gentleman who presented with a painless midline neck swelling since 6 years. Onset of the swelling was insidious and gradually increased in size over the years.Patient did not give any history suggestive of an infection or thyroid gland dysfunction. MRI of the Neck revealed a 3.5 x 3 x 3.5 cm well-defined lesion in the anterior neck suggesting a Thyroglossal Cyst.

Patient was worked up for a sistrunk’s procedure. Histopathology revealed a well- differentiated Papillary Thyroid Carcinoma. Thyroglossal duct Cyst in adulthood is a rare entity as most of the case usually presented at childhood. Presence of a Thyroglossal Cyst in an adult should prompt the caregiver to evaluate for a malignant change. Sistrunks procedure remains the standard treatment of choice for all the age groups. Infection of the cyst remains the most common complication of Thyrglossal cyst.