Thyroglossal Duct Remnant with Follicular Hyperplasia Presenting After Total Thyroidectomy.
BACKGROUND
The thyroglossal duct fails to involute in up to 7% of adults, creating a thyroglossal duct remnant (TGDR) attached to the hyoid bone. Thyroid malignancies have been reported in approximately 1% of TGDRs. In previous reports of TGDR carcinoma, patients had radiographic evidence of a TGDR at initial clinical presentation. Alternatively, hypertrophy of a TGDR is well described in patients with hypothyroidism because of the growth of functional ectopic thyroid tissue. We present the case of a patient who had no radiographic evidence of a TGDR prior to thyroidectomy but presented 14 months after surgery with a recurrent cervical mass.


METHODS
A 58-year-old female underwent total thyroidectomy for micropapillary thyroid cancer. Fourteen months later, she presented with an enlarging cervical mass. She underwent a Sistrunk procedure, and surgical pathology revealed a TGDR with compensatory glandular hypertrophy.


CONCLUSIONS
To our knowledge, this is the first report of a TGDR follicular adenoma initially appearing as a result of compensatory thyroid glandular hypertrophy following total thyroidectomy for a micropapillary thyroid carcinoma. Our case presented a novel clinical dilemma regarding the best management for a patient with a new TGDR along with a recent history of micropapillary thyroid cancer.
Department of Otolaryngology - Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA.
Ryan E
RE
Nelson
Department of Otolaryngology - Head and Neck Surgery, Rosalind Franklin University of Medicine and Science, Chicago Medical School, North Chicago, IL.
Hassan
H
Ahmad
Department of Otolaryngology - Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA ; Department of Otolaryngology - Head and Neck Surgery, Ochsner Clinic Foundation, New Orleans, LA.
Douglas M
DM
Hildrew
Department of Otolaryngology - Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA ; Department of Otolaryngology - Head and Neck Surgery, Ochsner Clinic Foundation, New Orleans, LA.
Claire M
CM
Lawlor
Department of Otolaryngology - Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA.
Rizwan
R
Aslam
Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA.
Andrew
A
Sholl
Department of Surgery - Endocrine and Oncologic Surgery, Tulane University School of Medicine, New Orleans, LA.
Emad
E
Kandil
Adenoma; thyroglossal cyst; thyroid cancer–follicular; thyroid cancer–papillary; thyroid neoplasms