Reporte de caso clínico: Carcinoma papilar en quiste del conducto tirogloso

Tatiana Elizabeth Jaramillo Herrera, Jonathan Adrian Abarca Cuenca, Luis Michael Cueva Villalta, Ana Luisa Pérez Bustan, Hernán Garrido Cisneros, Pablo Fernando Ortega Espinoza
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Abstract

BACKGROUND: Thyroglossal duct cysts occur in approximately 7% of the adult population. In children, it is the most common cervical congenital anomaly, with a frequency of 70%. Intracystic malignancy is very rare, it occurs in less than 1% of cases, with a mean age of 40 years and predominance in women. CASE REPORT: 29-year-old female patient, with no significant medical background. She consulted for a “lump” in the front neck, which had been slowly growing for three years, and did not produce any symptoms. Physical examination and complementary imaging tests resulted in the diagnosis of an occupational lesion compatible with a thyroglossal cyst. Sistrunk surgery was performed. EVOLUTION: During the surgical procedure, a mass was identified over the hyoid bone, macroscopically compatible with a thyroglossal duct cyst; however, the histopathology report showed papillary thyroid carcinoma within the cyst. The case was discussed; it was decided to only indicate control and follow-up. The patient has been on follow up for 30 months, without recurrence to date. CONCLUSION: Although its incidence is low, papillary thyroid carcinoma can present within a thyroglossal duct cyst; the incidence is slightly higher in female population. Diagnosis in most cases is made after surgical treatment. The treatment choice must be individualized in each case, depending on the risk of recurrence and metastasis, following the current established recommendations.
临床病例报告:甲状腺管囊肿乳头状癌
背景:甲状腺舌管囊肿发生在大约7%的成年人中。在儿童中,它是最常见的宫颈先天性异常,发生率为70%。囊内恶性肿瘤非常罕见,发生率不到1%,平均年龄40岁,以女性为主。病例报告:29岁女性患者,无显著医学背景。她咨询了前颈部的一个“肿块”,这个肿块已经缓慢生长了三年,没有产生任何症状。体格检查和辅助影像学检查诊断为职业性病变伴甲状舌囊肿。行Sistrunk手术。进展:在手术过程中,舌骨上方发现肿块,宏观上与甲状舌管囊肿相符;然而,组织病理学报告显示囊肿内为甲状腺乳头状癌。讨论了这个案子;决定只指示控制和随访。患者随访30个月,无复发。结论:甲状腺乳头状癌虽发病率低,但可出现在甲状腺舌管囊肿内;在女性人群中发病率略高。大多数病例的诊断是在手术治疗后做出的。治疗选择必须根据复发和转移的风险,根据目前的建议进行个体化治疗。
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