Papillary Carcinoma Arising in a Thyroglossal Duct Cyst: A Case Report and Review of the Literature

Background Thyroglossal duct cysts (TGDCs) represent the most common congenital cervical anomalies resulting from incomplete involution of the thyroglossal duct during embryologic development. Malignant transformation within a TGDC is rare, occurring in approximately 1–1.5% of cases , with papillary carcinoma being the most frequent histological type. Case Presentation We report the case of a 30-year-old woman presenting with a midline cervical swelling evolving over four years. Clinical examination revealed a firm, painless anterior cervical mass that was mobile with tongue protrusion . Imaging studies suggested a multiloculated thyroglossal duct cyst with a solid component . The patient underwent a Sistrunk procedure . Histopathological examination revealed papillary thyroid carcinoma measuring 1.5 cm arising within the thyroglossal duct cyst. Following multidisciplinary discussion, completion thyroidectomy was recommended but declined by the patient . Conclusion Papillary carcinoma arising in TGDC is rare and often diagnosed incidentally after surgical excision. The optimal therapeutic strategy remains controversial, particularly regarding the need for additional thyroidectomy. The Sistrunk procedure remains the cornerstone of treatment , while further management should be individualized according to clinical, radiological, and histopathological findings.