Papillary carcinoma with extensive squamous metaplasia arising from thyroglossal duct cyst in an 11-year-old girl: significance of differentiation from squamous cell carcinoma: a case report

Abstract We report a case of papillary carcinoma (PC) with extensive squamous metaplasia arising from a thyroglossal duct cyst (TDC) that required differential diagnosis from squamous cell carcinoma (SCC). An 11-year-old Japanese girl presented with a 9-month history of an anterior-midline neck mass...

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Bibliographic Details
Published in:Journal of pediatric surgery 2011-04, Vol.46 (4), p.e1-e4
Main Authors: Gomi, Kiyoshi, Kitagawa, Norihiko, Usui, Yoshiko, Tanaka, Mio, Yoshida, Mariko, Hirata, Yoshihiro, Kosaka, Taiichiro, Honda, Shohei, Take, Hiroshi, Shinkai, Masato, Shishikura, Ayako, Aida, Noriko, Ohhama, Youkatsu, Tanaka, Yukichi
Format: Article
Language:English
Subjects:
Biopsy
Carcinoma, Papillary - diagnosis
Carcinoma, Papillary - surgery
Carcinoma, Squamous Cell - diagnosis
Cell Differentiation
Child
Diagnosis, Differential
Female
Humans
Metaplasia
Papillary carcinoma
Pediatric
Pediatrics
Squamous metaplasia
Surgery
Thyroglossal Cyst - diagnosis
Thyroglossal Cyst - surgery
Thyroglossal duct cyst
Thyroid Gland - diagnostic imaging
Thyroid Gland - pathology
Thyroid Neoplasms - diagnosis
Thyroid Neoplasms - surgery
Thyroidectomy
Tomography, X-Ray Computed
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Summary:Abstract We report a case of papillary carcinoma (PC) with extensive squamous metaplasia arising from a thyroglossal duct cyst (TDC) that required differential diagnosis from squamous cell carcinoma (SCC). An 11-year-old Japanese girl presented with a 9-month history of an anterior-midline neck mass that was clinically diagnosed as TDC. Open neck biopsy revealed nested proliferation of atypical squamous cells within the cystic structures, and SCC arising from TDC was initially suspected. Further examination, however, including immunohistochemistry, revealed the tumor to be of thyroid cell origin. The patient underwent wide local resection of the thyroglossal duct carcinoma by Sistrunk procedure and cervical lymph node dissection. Microscopically, the diagnosis was of PC with extensive squamous metaplasia and metastasis to the medial submandibular lymph node. Distinction of squamous metaplasia in PC from SCC is sometimes difficult, but has a significant effect on postoperative management.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2010.10.030