THYROGLOSSAL DUCT CARCINOMA - A RATIONAL APPROACH TO MANAGEMENT

Objective: To discuss the authors' experience with thyroglossal duct c arcinoma and present a rational approach to the management of this ent ity. Study Design and Methods: A retrospective review of the cytopatho logy and pathology records of all patients with the diagnosis of a thy roglossal duct remnant from 1965 to 1997 was performed. Results: Three cases of papillary thyroglossal duct carcinoma were identified, with one suspected squamous cell carcinoma by needle aspiration. The papill ary carcinomas are discussed in detail to illustrate the difficulty en countered in managing the thyroid gland in the setting of a thyrogloss al duct carcinoma. Fine-needle aspiration proved effective in making t he diagnosis preoperatively. Conclusions: The authors recommend that a thyroglossal duct cyst with a microscopic focus of papillary carcinom a, without cyst wall invasion, be managed with a Sistrunk procedure. T reatment of all other thyroglossal duct papillary carcinomas should in clude removal of all thyroid tissue followed by radioactive iodine tre atment.