Carcinoma en quiste tirogloso

differentiated thyroid carcinoma (dtc) in thyroglosal duct cyst (tgdc) is rare, ranging from 0.7 to 1.07% in different series. after the surgery of choice (sistrunk procedure) the other alternative treatments such as thyroidectomy (tx), radioiodine and l-t4 therapy are controversial. objective: to evaluate several and controversial aspects in the largest series of dtc in tgdc reported in the literature. subjects and methods: retrospective multicentric study: n= 22, aged 10-69 yrs. (15 females and 7 men) who underwent the sistrunk procedure for tgdc. results: none of the tgdc was less than 1 cm (median 3.0 cm, χ±sd= 3.7 ± 2.2cm). in half of them there was an increased cystic size in the last 6 months before surgery. cyst fna was suspicious in 2/5 and positive in one, whereas the histological diagnosis of the operated tgcd was papillary cancer in 21 and 1 follicular carcinoma. thyroid ultrasound (us) (n=13) showed nodules in 30% of the cases. tx was performed in 17/22 (total: 15, subtotal: 2). thyroid dtc coexisted in 4/17 (23.5%), and was unilateral in all of them. lymph node metastases were present in 2 adults and muscle involvement was found in the 10-year old girl. none of these 3 patients had overt thyroid lesions. 131-i therapy was performed in 10 patients. in 9 out of 11 subjects tg remained undetectable during follow-up (1-14yrs.). persistent high tg was present in one case without thyroid dtc. conclusions: 1) ultrasonography and fnab should be performed to every patient with thyroglossal duct cyst 2) in case of tgdc, total tx and sistrunk's procedure should be simultaneously combined 3) 131-i therapy and l-t4 suppressive treatment should be evaluated in every case 4) follow-up as in the dtc.