Can Medullary Thyroid Carcinoma Arise in Thyroglossal Duct Cysts? A Search for Parafollicular C-cells in 41 Resected Cases
- 96 Downloads
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.
KeywordsMedullary Thyroid Carcinoma Thyroglossal Parafollicular C-cells
Compliance with Ethical Standards
Conflict of interest
The authors have no conflict of interest to report.
- 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
- 7.Deshpande A, Bobhate SK. Squamous cell carcinoma in thyroglossal duct cyst. J Laryngol Otol. 1995;109(10):1001–4. http://www.ncbi.nlm.nih.gov/pubmed/7499934.
- 8.Mobini J, Krouse TB, Klinghoffer JF. Squamous cell carcinoma arising in a thyroglossal duct cyst. Am Surg. 1974;40(5):290–4. http://www.ncbi.nlm.nih.gov/pubmed/4821352.
- 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. http://www.ncbi.nlm.nih.gov/pubmed/8697325.
- 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.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
- 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. http://www.ncbi.nlm.nih.gov/pubmed/23771071.
- 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