Head and Neck Pathology

, Volume 12, Issue 1, pp 71–74 | Cite as

Can Medullary Thyroid Carcinoma Arise in Thyroglossal Duct Cysts? A Search for Parafollicular C-cells in 41 Resected Cases

  • Tracy Stein
  • Paari Murugan
  • Faqian Li
  • Mohamed I. El Hag
Original Paper


Thyroglossal duct cysts (TGDCs) are present in ~7% of adults and develop from the midline migratory tract between the foramen cecum and anatomic location of the thyroid. Thyroid tissue can be identified in 2/3 of TGDCs, and up to 1% develop associated malignancy, 90% of which are papillary thyroid carcinoma. Cases of follicular and anaplastic carcinoma have been documented, but there are no reports of medullary thyroid carcinoma arising in a TGDC. This is presumably due to the distinct embryologic origin of parafollicular C-cells, from which medullary carcinoma arises. The goal of this study is to determine whether parafollicular C-cells are present in TGDCs. H&E sections from 41 TGDC cases were examined for thyroid tissue, thyroglossal duct remnants, ultimobranchial remnants, and parafollicular C-cells. Immunohistochemistry was performed for TTF-1 and calcitonin. Eighty three percent (34/41) of cases contained thyroid tissue on H&E and by TTF-1. No cases (0/41) had ultimobranchial remnants or parafollicular C-cells on H&E or with calcitonin. One case of papillary carcinoma in a TGDC was identified. These cases illustrate that although TGDCs often contain thyroid tissue, parafollicular C-cells are absent. Therefore, unlike other thyroid neoplasms, there is no evidence to support the possibility of medullary carcinoma arising in a TGDC.


Medullary Thyroid Carcinoma Thyroglossal Parafollicular C-cells 


Compliance with Ethical Standards

Conflict of interest

The authors have no conflict of interest to report.


  1. 1.
    Chou J, Walters A, Hage R, et al. Thyroglossal duct cysts: anatomy, embryology and treatment. Surg Radiol Anat. 2013;35(10):875–81. doi: 10.1007/s00276-013-1115-3.CrossRefPubMedGoogle Scholar
  2. 2.
    Mazzaferri EL. Thyroid cancer in thyroglossal duct remnants: a diagnostic and therapeutic dilemma. Thyroid. 2004;14(5):335–6. doi: 10.1089/105072504774193140.CrossRefPubMedGoogle Scholar
  3. 3.
    Livolsi VA, Perzin KH, Savetsky L. Carcinoma arising in median ectopic thyroid (including thyroglossal duct tissue). Cancer. 1974;34(4):1303–15. doi: 10.1002/1097-0142(197410)34:4<1303::AID-CNCR2820340442>3.0.CO;2-S.CrossRefPubMedGoogle Scholar
  4. 4.
    Motmed M, McGlashan JA. Thyroglossal duct carcinoma. Curr Opin Otolaryngol Head Neck Surg. 2004;12(2):106–9. doi: 10.1097/00020840-200404000-00009.CrossRefGoogle Scholar
  5. 5.
    Wei S, LiVolsi VA, Baloch ZW. Pathology of thyroglossal duct: an institutional experience. Endocr Pathol. 2015;26(1):75–9. doi: 10.1007/s12022-015-9354-y.CrossRefPubMedGoogle Scholar
  6. 6.
    Chang Y-S, Su H-H, Ho S-P. Adenosquamous carcinoma arising from a thyroglossal duct cyst: a case report. Oncol Lett. 2016;11(4):2668–72. doi: 10.3892/ol.2016.4262.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Deshpande A, Bobhate SK. Squamous cell carcinoma in thyroglossal duct cyst. J Laryngol Otol. 1995;109(10):1001–4.
  8. 8.
    Mobini J, Krouse TB, Klinghoffer JF. Squamous cell carcinoma arising in a thyroglossal duct cyst. Am Surg. 1974;40(5):290–4.
  9. 9.
    Thompson LDR, Herrera HB, Lau SK. A clinicopathologic series of 685 thyroglossal duct remnant cysts. Head Neck Pathol. 2016;10(4):465–74. doi: 10.1007/s12105-016-0724-7.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Kwan WB, Liu FF, Banerjee D, Rotstein LE, Tsang RW. Concurrent papillary and squamous carcinoma in a thyroglossal duct cyst: a case report. Can J Surg. 1996;39(4):328–32.
  11. 11.
    Utiger RD. Medullary thyroid carcinoma, genes, and the prevention of cancer. N Engl J Med. 1994;331(13):870–1. doi: 10.1056/NEJM199409293311309.CrossRefPubMedGoogle Scholar
  12. 12.
    Schmid KW. Histopathology of C cells and medullary thyroid carcinoma. Recent Results Cancer Res. 2015;204:41–60. doi: 10.1007/978-3-319-22542-5_2.CrossRefPubMedGoogle Scholar
  13. 13.
    Donoghue PCJ, Graham A, Kelsh RN. The origin and evolution of the neural crest. Bioessays. 2008;30(6):530–41. doi: 10.1002/bies.20767.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Fagman H, Nilsson M. Morphogenesis of the thyroid gland. Mol Cell Endocrinol. 2010;323(1):35–54. doi: 10.1016/j.mce.2009.12.008.CrossRefPubMedGoogle Scholar
  15. 15.
    Johansson E, Andersson L, Ornros J, et al. Revising the embryonic origin of thyroid C cells in mice and humans. Development. 2015;142(20):3519–28. doi: 10.1242/dev.126581.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Hirsch MS, Faquin WC, Krane JF. Thyroid transcription factor-1, but not p53, is helpful in distinguishing moderately differentiated neuroendocrine carcinoma of the larynx from medullary carcinoma of the thyroid. Mod Pathol. 2004;17(6):631–6. doi: 10.1038/modpathol.3800105.CrossRefPubMedGoogle Scholar
  17. 17.
    Smets G, Warson F, Dehou MF, et al. Metastasizing neuroendocrine carcinoma of the larynx with calcitonin and somatostatin secretion and CEA production, resembling medullary thyroid carcinoma. Virchows Arch A Pathol Anat Histopathol. 1990;416(6):539–43. doi: 10.1007/BF01600306.CrossRefPubMedGoogle Scholar
  18. 18.
    Sameer KSM, Mohanty S, Correa MMA, Das K. Lingual thyroglossal duct cysts—a review. Int J Pediatr Otorhinolaryngol. 2012;76(2):165–8. doi: 10.1016/j.ijporl.2011.11.025.CrossRefPubMedGoogle Scholar
  19. 19.
    Milojevic B, Tosevski J, Milisavljevic M, Babic D, Malikovic A. Pyramidal lobe of the human thyroid gland: an anatomical study with clinical implications. Rom J Morphol Embryol. 2013;54(2):285–9.
  20. 20.
    Prakash, Rajini T, Ramachandran A, Savalgi GB, Venkata SP, Mokhasi V. Variations in the anatomy of the thyroid gland: clinical implications of a cadaver study. Anat Sci Int. 2012;87(1):45–9. doi: 10.1007/s12565-011-0115-9.CrossRefPubMedGoogle Scholar
  21. 21.
    Sadat A, Nurunnabi M, Alim A, Mahbub S, Kishwara S. Morphological and histological study of the pyramidal lobe of the thyroid gland in Bangladeshi people—a postmortem study. Bangladesh J Anat. 2009;7(2):94–100.Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Tracy Stein
    • 1
  • Paari Murugan
    • 2
  • Faqian Li
    • 2
  • Mohamed I. El Hag
    • 3
  1. 1.University of Minnesota Medical SchoolMinneapolisUSA
  2. 2.Department of PathologyUniversity of Minnesota Medical CenterMinneapolisUSA
  3. 3.Department of Anatomic PathologyUniversity of Pittsburgh Medical CenterPittsburghUSA

Personalised recommendations