Carcinoma in thyroglossal duct remnants.Review of literature and report of 2 cases

EXTREMELY rare thyroid neoplasm is one A that develops in a thyroglossal remnant.We have been able to find reports of only 5 cases in the medical literature.However, 2 cases were found at the Ochsner Clinic among 116 ptients with thyroglossal duct remnants seen (1.7%) and 69 who were treated by operation (3.z.) since 1945.It is the purpose of this paper to report these 2 cases and to review the pertinent data of the 5 recorded cases. CASE REPORTSCase 1.A white girl, aged 9 years, came to the Ochsner Clinic on March 9, 1945, because of a "lump" in the neck.The mother had first noticed a swelling in the mid-line of the neck when the child was 2 years old.The mass had increased very little in size until 1 year before admission, when it began to grow more rapidly.The only abnormality on physical examination was a smooth, firm mass, 2.25 cm. in diameter, in the mid-line of the neck above the hyoid bone.Multiple lymph nodes were palpable bilaterally in the neck.A diagnosis of thyroglossal duct cyst was made.On March 13, 1945, after general endotracheal anesthesia had been induced, a transverse incision was made over the mass.The cyst extended from the hyoid bone to the cecal foramen of the tongue.The mid-portion of the hyoid bone was removed in continuity with the mass, and the mucous membrane of the tongue in the region of the cecal foramen was removed in continuity with the tumor.The excised specimen measured 3.X2.x 1.5 cm.Its external surface was covered with numerous tags of fibrous and adipose tissue.A segment of bone measuring 2.xl.xO.3 cm. was firmly attached to one aspect of the mass.The specimen was firm, and sections revealed grayish-white to red cut surface.One small cystic area lined by grayish-white membrane presented multiple folds.Attached to the external surface oE the specimen was 1 small lymph node measuring approximately 4 mm. in di-