Papillary carcinoma in thyroglossal duct remnants: Presentation of four cases and decision procedure for prophylactic thyroid gland dissection

Papillary carcinoma in thyroglossal duct remnants is a rare and usually une xpected finding. It is controversial whether or not prophylactic thyroid gl and dissection is necessary in such circumstances. We present our experienc e of four cases. Based on this, a consideration of published risk factors, and evaluation of the likelihood of a primary versus metastatic origin of t he malignancy, we present a therapeutic decision procedure. When the thyroi d is normal, the patient presents low-risk factors for thyroid cancer, and there is evidence that the malignancy is primary, removal of all thyrogloss al duct remnants by the Sistrunk procedure is sufficient.