Total Laryngectomy for Squamous Cell Carcinoma Arising from a Thyroglossal Duct Cyst

Additional Authors

Paul Jones, Department of Medical Education, Quillen College of Medicine, East Tennessee State University, Johnson City, TN. Phillip Nichols, Department of Medical Education, Quillen College of Medicine, East Tennessee State University, Johnson City, TN. Caleb Brown, Department of Medical Education, Quillen College of Medicine, East Tennessee State University, Johnson City, TN. Kenneth Lewozcko, East Tennessee Ear, Nose, & Throat Associates, Johnson City, TN.

Abstract

Carcinoma arising from a thyroglossal duct cyst (TGDC) is uncommon. Most cases originate from thyroid tissue making squamous cell carcinoma exceptionally rare. Due to its rarity, no standardized treatment exists, and physicians rely on case studies and expert opinions. The Sistrunk procedure is the standard of care for TGDC excision, but additional interventions are guided by the extent of malignancy. This case is unique in describing SCC from a TGDC invading the thyroid cartilage, requiring a total laryngectomy. A 60-year-old male with a significant smoking history presented with acute anterior neck pain, swelling, and fever. Imaging revealed a cystic midline neck mass suspicious for malignancy. Initial treatment with antibiotics alleviated symptoms, but the mass persisted. Surgical biopsy confirmed SCC arising from a TGDC with invasion into the thyroid cartilage and tongue base. Multidisciplinary evaluation determined the tumor as T4aN0M0 SCC. The patient underwent total laryngectomy, bilateral neck dissections, and adjuvant radiotherapy. Pathology revealed p16-negative SCC involving the TGDC and a separate T1a SCC of the epiglottis. TGDCs form due to incomplete involution of the thyroglossal tract during embryogenesis, and squamous cell carcinoma within them is exceedingly rare. Diagnosis requires confirmation of SCC within the TGDC wall, with transition zones and exclusion of adjacent malignancies. This presentation underscores the need for tailored approaches, as conventional Sistrunk procedures may be inadequate for advanced disease. We present a total laryngectomy as a viable treatment for TGDC-associated SCC with laryngeal invasion. Further research is essential to establish evidence-based guidelines for this rare malignancy.

Start Time

16-4-2025 1:30 PM

End Time

16-4-2025 4:00 PM

Presentation Type

Poster

Presentation Category

Health

Student Type

Clinical Doctoral Student (e.g., medical student, pharmacy student)

Faculty Mentor

Lou Smith

Faculty Department

Surgery

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Apr 16th, 1:30 PM Apr 16th, 4:00 PM

Total Laryngectomy for Squamous Cell Carcinoma Arising from a Thyroglossal Duct Cyst

Carcinoma arising from a thyroglossal duct cyst (TGDC) is uncommon. Most cases originate from thyroid tissue making squamous cell carcinoma exceptionally rare. Due to its rarity, no standardized treatment exists, and physicians rely on case studies and expert opinions. The Sistrunk procedure is the standard of care for TGDC excision, but additional interventions are guided by the extent of malignancy. This case is unique in describing SCC from a TGDC invading the thyroid cartilage, requiring a total laryngectomy. A 60-year-old male with a significant smoking history presented with acute anterior neck pain, swelling, and fever. Imaging revealed a cystic midline neck mass suspicious for malignancy. Initial treatment with antibiotics alleviated symptoms, but the mass persisted. Surgical biopsy confirmed SCC arising from a TGDC with invasion into the thyroid cartilage and tongue base. Multidisciplinary evaluation determined the tumor as T4aN0M0 SCC. The patient underwent total laryngectomy, bilateral neck dissections, and adjuvant radiotherapy. Pathology revealed p16-negative SCC involving the TGDC and a separate T1a SCC of the epiglottis. TGDCs form due to incomplete involution of the thyroglossal tract during embryogenesis, and squamous cell carcinoma within them is exceedingly rare. Diagnosis requires confirmation of SCC within the TGDC wall, with transition zones and exclusion of adjacent malignancies. This presentation underscores the need for tailored approaches, as conventional Sistrunk procedures may be inadequate for advanced disease. We present a total laryngectomy as a viable treatment for TGDC-associated SCC with laryngeal invasion. Further research is essential to establish evidence-based guidelines for this rare malignancy.