A case of papillary carcinoma arising in ectopic thyroid tissue within a branchial cyst with neck node metastasis

Department of Surgery, Erne Hospital, Enniskillen, County Fermanagh, Northern Ireland.
Ear, nose, & throat journal (Impact Factor: 1). 11/2006; 85(10):675-6.
Source: PubMed


We describe the interesting case of a young man who presented with a lateral neck node that was diagnosed as a branchial cyst. Histopathology of the excised node revealed that a papillary carcinoma was located within thyroid tissue, which in turn was located within a branchial cyst. A total thyroidectomy with local lymph node clearance was performed. Histology identified a normal thyroid gland, but a papillary carcinoma in one of the excised lymph nodes was consistent with a metastasis. To our knowledge, this is only the second reported case of a thyroid carcinoma arising in ectopic thyroid tissue that metastasized in the neck.

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    • "Branchial cleft cysts are the most common lateral cystic neck masses. Ectopic thyroid tissue within a branchial cleft cyst is a rare phenomenon, and papillary thyroid carcinoma (PTC) arising from this tissue is extremely rare [1] [2]. "
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    ABSTRACT: We report a rare case of papillary thyroid carcinoma incidentally found within a branchial cleft cyst. Only four other cases have been described in the literature. A total thyroidectomy and selective neck dissection was performed, and no evidence of occult primary disease was found after review of fine sections. Branchial cleft cysts are the most common lateral neck masses. Ectopic thyroid tissue within a branchial cleft cyst is an unusual phenomenon, and papillary thyroid carcinoma arising from this tissue is extremely rare. Clinicians are left with a diagnostic dilemma when presented with thyroid tissue neoplasm within a neck cyst in the absence of a thyroid primary-is this a case of metastatic disease with a missed primary or rather carcinoma arising in ectopic thyroid tissue? A thorough discussion of the etiologies of these lateral neck masses is reviewed including the embryogenesis of thyroid tissue in a branchial cleft cyst. The prognosis of patients with papillary thyroid carcinoma in lateral neck cysts without a primary site identified appears to be good following excision of the cyst and total thyroidectomy. Other management recommendations regarding these unique lateral neck malignancies are also presented.
    07/2013; 2013(10):405342. DOI:10.1155/2013/405342
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    • "Papillary carcinoma arising from branchial remnants has the ability to metastasize to regional lymph nodes. Neck node metastases are found in 20% [9,10], but distant metastases were not reported. "
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    ABSTRACT: Although branchial cleft cysts are common, papillary carcinomas arising from them are rare. Here we report a 41-year-old woman with papillary carcinoma originating from a right lateral branchial cleft cyst without any evidence of a papillary carcinoma in the thyroid gland. The patient underwent right lateral neck dissection followed by total thyroidectomy. We then confirmed papillary carcinoma arising from the branchial cleft cyst through microscopic and immunohistochemical staining with thyroglobulin (TG), thyroid-associated transcription factor-1 (TTF-1) and p63. It is the 10th case worldwide describing papillary carcinoma in a branchial cleft cyst with a review of the literature on the features of the disease and discussion of the role of immunohistochemical staining with TG, TTF -1 and p63. In conclusion, it should be emphasized that the surgeon must be cautioned of the possibility of primary papillary carcinoma in the branchial cleft cyst.
    12/2011; 81 Suppl 1(Suppl 1):S12-6. DOI:10.4174/jkss.2011.81.Suppl1.S12
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    ABSTRACT: Ectopic thyroid gland (ETG) is a rare entity. It may be located anywhere from the base of the tongue to mediastinum, and seldom in other sites. Most of the patients usually present with midline swelling which can be easily confused with other midline pathology, thereby leading to mismanagement in the form of surgical excision. The diagnosis of this entity requires clinical examination and different imaging modalities for proper management. Radionuclide studies play an important role in the diagnosis and further management of patients with ETG. In the present review we shall discuss various issues about location, embryology, clinical presentation and management including treatment of ETG.
    Hellenic journal of nuclear medicine 09/2008; 11(3):168-71. · 0.99 Impact Factor
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