To the Editor.—
The report by Chandrasoma and Janssen (1982;247:1406) of a thyroglossal cyst lined by gastric epithelium is intriguing from an embryologic and a clinical perspective. However, we wish to indicate that thyroglossal cysts are not "universally benign" as claimed.The literature contains reference to some 90 examples of carcinoma in the thyroglossal tract, mostly of the papillary type.1-5 In as many as 25% of cases, carcinoma may be present elsewhere in the thyroid gland.3 The prognosis for patients with this neoplasm appears to be excellent,2 but recently a fatality due to anaplastic carcinoma that arose in a thyroglossal duct remnant was reported.5 Since seven patients with this disorder were observed in our institution during the past ten years2 (additional manuscript submitted for publication), it is possible to speculate that a malignant neoplasm in a thyroglossal duct actually may not be terribly rare.
Blum M, Roses DF, Cohen N. Thyroglossal Duct Carcinoma. JAMA. 1982;248(8):924. doi:10.1001/jama.1982.03330080014014
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