I agree with Dr Blum and colleagues that a cystic lesion in the front of the neck may on occasion be a cystic thyroid carcinoma. This is a primary tumor that has its origin in ectopic thyroid follicles occurring in the line of the thyroglossal duct.1 Such ectopic thyroid tissue may occur with or without an associated thyroglossal cyst.2It is important to distinguish lesions of the thyroglossal duct epithelium from those related to ectopic thyroid tissue. The former, from which thyroglossal cysts arise, usually differentiates into pharyngeal-type epithelia. Although theoretically possible, I have not seen reference to thyroid acinar cells lining a thyroglossal cyst. While it has been reported, the occurrence of squamous carcinoma arising from thyroglossal duct epithelium has not been demonstrated convincingly.1Ectopic thyroid tissue in the line of the thyroglossal duct may rarely undergo malignant change.1,2 Such tumors are solid,
Chandrasoma P. Thyroglossal Duct Carcinoma-Reply. JAMA. 1982;248(8):924. doi:10.1001/jama.1982.03330080014015
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