CONGENITAL THYROID TERATOMA - A CASE WITH PERSISTENT NEUROGLIAL INVOLVEMENT OF CERVICAL LYMPH-NODES

A case of congenital thyroid teratoma with nodal spread is reported. P rimary surgery was performed on a female infant on the 6th day of life . The thyroid mass was removed in tote, and an adjacent 1.2 cm lymph n ode was also removed. Histology showed solid and cystic teratoma with a variety of elements including prominent neuroglial tissue that was n euroblastoma-like in places. Residual compressed non-neoplastic thyroi d tissue was identified in the subcapsular plane. The lymph node was l argely replaced by neuroglial tissue that was cellular in some areas a nd showed intrasinusoidal growth and some mitotic activity. Recurrent cervical lymphadenopathy gradually developed, commencing a few months after surgery. Excision of cervical nodes was undertaken at 9 months o f age. About 13 nodes up to 2 cm in diameter were excised. Most of the specimens consisted of reactive lymph nodes, but in three of the smal ler nodes, there were subcapsular and sinusoidal masses of focally cel lular neuroglial tissue, again with occasional mitoses. This tissue st ained strongly for glial fibrillary acidic protein, in addition to exp ressing neural markers. The lymph node ''deposits'' were interpreted a s ''displaced'' lesional tissue rather than metastases in the usual, a ggressive sense. The girl remains well at 5 years of age.